2004-08-05_REPORT - M1998105

• Permit No: M1998105
• IBM Index Class Name: Report
• Doc Date: 8/5/2004
• Doc Name: Annual Fee/Report/Map
• From: Grand Junction Pipe & Supply Co.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNPJERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Grand Junction Pipe & Supply Co.
M-1998-105
Delta Paving Gravel Pit
August 6, 2004
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RE~~IVE®
AUGOg~
Division o1 h'lineials and Ceolagy
$688.00 (Due on or before your anniversary date)
Delta
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reciamation accomplished-to-date-and-during-the-preceding-year,-new-dis~srbances-that-are-anticipated-to-escur-
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written anm~al rennrt and annnal rennrt mgp to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a writteu report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Edward J. Settle
Permittee Name: Grand Junction Pipe & Supply Co.
Address: P.O. Box 1849
Grand Junction, CO 81502
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
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Signature o Corporate Officer, Owner, or Designee
_z-o4
Date