REP48491

• Permit No: M1997100
• IBM Index Class Name: Report
• Doc Date: 1/20/2004
• Doc Name: 2004 Annual Report
• From: Las Animas County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

DEC 1 5 2003
' \YJ
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Las Animas County
M-1997-100
Branson Gravel Pit
January 16, 2004
$281.00 (Due on or before your anniversary date)
Las Animas - 5
~~'
Division of Minenli A f1191B9'{
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each~ear,~aihe_annivErsary_date-of-_the-permit,-an= }-----
-_____ _-- operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected
-- -]and,-reclamation-accomplished-to-date-and-during the-preeeding-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 your revised written annnal rennrt and anm~al rennrt m ~n fn this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Phil Dorenkamp
Permittee Name: Las Animas County
Address: 2000 N. Linden Ave.
Trinidad, CO 81082
-- - - Pirot[e-Nitmbne.~-(919}846=293•}- -- --- _ - _ --
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.
Signature of Corporate Officer, ner, or Designee
~/B/ s~
~ Date
M:IPERM ITVNASTERDOCUMENTSU4-AF-04