2001-09-14_REPORT - M1976018

• Permit No: M1976018
• IBM Index Class Name: Report
• Doc Date: 9/14/2001
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

999
ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME: North Weld Gravel RECTIVEC
PERMIT NO.: M-1976-018 SEP 1 4 7r
OPERATION NAME: North Weld Gravel (Division of Mineral:
ANNIVERSARY DATE: October 17, 2001
ANNUAL FEE DUE: $688.00(Due on or before your anniversary date)
COUNTY: Weld
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 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 your revised written annual report and annual report map to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice fora written report.
This pit is gwork11ed less than 21 (twenty—one) days a year. There is no increase in acres
tlTivisionvrecor8s IIm1UIC8te'[he°fo owlna p Frttli�feeb�or�t �t WFr{iat��H'.e OfAPPveFifgvA'?luffia�ce%ny nec�oaDhave,
changes:
Permittee Contact: Leroy A. Bellmore
Permittee Name: North Weld Gravel
Address: 13480 WCR 100
Nunn, CO 80648-9700
Phone Number: [phone]
Fax Number:
If you have additional comments and/or information that should be provided to the Divisior, 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 or Owner
September 11 , 2001
Date
M APERM ITMASTERDOCUNIENTSVA-AF-01