2004-06-24_REPORT - M1984069

• Permit No: M1984069
• IBM Index Class Name: Report
• Doc Date: 6/24/2004
• Doc Name: Annual Fee/Report/Map
• From: Schmalz Construction Ltd.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANMIAi, FF.F. and REPORT RF.niiF.ST
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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Schmalz Construction Ltd.
M-1984-069
Schmalz Const Pit
July 12, 2004
$281.00 (Due on or before your anniversary date)
Gunnison
rr
RECEAVEC
JUN 2 4 2004
Dlelafon of Minerals & Geology
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 I
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 I
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.
PI ae se~ttach yn ~r revised written annual renn and ann ral re nn rt matn to 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: Fred Schmalz
Permittee Name: Schmalz Construction Ltd.
Address: 720 S. 8th St.
P.O. Box 1105
Gunnison, CO 81230
Phone Number: [phone]
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. Annua] Report instructions are enclosed.
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Signature o Corporate Officer, Owne , or Designee
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Date ~