2005-12-21_REPORT - M1996049

• Permit No: M1996049
• IBM Index Class Name: Report
• Doc Date: 12/21/2005
• Doc Name: Annual Fee/Report/Map
• From: Everist Materials LLC
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Everist Materials, LLC
M-1996-049
Maryland Creek Ranch
December 20, 2005
$688.00 (Due on or before your anniversary date)
Summit
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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
- -sfiali su-bmit the ann--ual-tee, a report and map slowing the extent of current d~stuibanoes to affected land,---
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming yeaz, 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 re~nr and annual r@ n~,P rt m~ 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:
Petmittee Contact: Greg Norwick
Permittee Name: Everist Materials, LLC
Address: P.O. Box 1150
Silverthorne, CO 80498
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. Annual Report instructions are enclosed.
Signatur orporate Officer, Owner, or Designee
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