2004-11-29_REPORT - M1986040

• Permit No: M1986040
• IBM Index Class Name: Report
• Doc Date: 11/29/2004
• Doc Name: Annual Fee/Report/Map
• From: Bear River Sand & Gravel
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

1"°
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Bear River Sand & Gravel
M-1986-040
Bear River S & G
November 20, 2004
~~!Cb' 2 SLUl)tr
$688.00 (Due on or before your anniversary date)
Routt
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_sh_owing the extent of current disturbances to affected land,_ __-^
reclamation accomphshed`to date and during the preceding yeai, 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 ynnr revised written annual re,~nrt and anneal report mad 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:
PermitteeContact: Lester Crawford ~~~G~
Permittee Name: Bear River Sand & Gravel
Address:
Phone Number:
P. O. Box 616
Oak Creek, CO 80467
[phone]
Fax Number:
A~
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.
-,nl' ~~n
SigrYature of Coiporate Officer, Owner, or Designee
~~~~~C/
Date