2007-08-24_REPORT - M1981309

• Permit No: M1981309
• IBM Index Class Name: Report
• Doc Date: 8/24/2007
• Doc Name: Annual Fee/Report/Map
• From: Mason King
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Mason King
M-1981-309
V.F. Smith Pit #5
August 27, 2007 _
$323.00 (Due on or before your anniversary date)
Washington
AUG 2 4 2007
Division of Reclamation,
Mining and Safety
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, reclamation accomplished to date--~~dunng t e prece tn`g 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 annual report and annual reuort mau to this form. The Annual
Report & Fee requirement is not met until we have received the following components: fee, report, and
associated moo. If no new disturbances or reclamation have occurred during the previous vear and no
new chances to the urevious year's moo are necessary.then no new moo is required, urovided that the
Operator shall state this in the Annual Report. 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: Mason King
Permittee Name: Mason King
Address: Box 68
Cope, CO 80812
Phone Number: [phone]
Fax Number:
If you have additional comments and/or information that should be provided to the Division, please provide it
belo/w~o~r attach it to this form along with your written report and map. Annual Report instructions are
end !' ~ `
Signature Corporate Officer, Owne •, or Designee _
Dale
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