2004-11-12_REPORT - M1978323

• Permit No: M1978323
• IBM Index Class Name: Report
• Doc Date: 11/12/2004
• Doc Name: Annual Fee/Report/Map
• From: Parkerson Construction Co.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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N®V 12 2004'
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Parkerson CMstruction Co.
M-1978-323
Woodring Pit
November 22, 2004
$688.00 (Due on or before your anniversary date)
Mesa
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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
sha~11 su6mr[ t e annua Yee, a report and- map showing the extent of current disturbance's to affected land,
reclamation accomplished to date and during the preceding year,-new disturbances that are anticipated to occur
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 y~ir revised written anmial rennrt and annnal report m ~n to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Alan Parkerson
Permittee Name: Parkerson Construction Co.
Address: 710 S. ISth St.
Grand Junction, CO 81501
Phone Number: [phone]
Fax Number: [phone]
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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.
Signature of orporate Officer, Owner, or Designee
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Date