2006-03-01_REPORT - M1983213

• Permit No: M1983213
• IBM Index Class Name: Report
• Doc Date: 3/1/2006
• Doc Name: Annual Fee/Report/Map
• From: Weld County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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t/ ANNiTAi. FF,F, and RF.PnRT RF.t7iIF.ST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
`~ Weld County
t/ M-1983-213
Lehr Gravel Pit
March 1, 2006
REC~IVrD
MAR 0`12006
/prvis~on of Minerals and Geolo9Y
$688.00 (Due on or before your anniversary date)
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-upcomingyear, reclamation that-will-be performed during the coming year,-tfie dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach ynnr revised written annnal report and annnal rennrt m ~n M 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 petTnittee contact information. Please verify and make any necessary
changes:
Permittee Contact:
Permittee Name:
Address:
Phone Number:
Fax Number:
Greg Nelson
Weld County
1111 H St
P.O. Box 758
Greeley, CO 80632
[phone]
[phone]
e
Q~
(970) ivy ~~ ti g6
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.
S ature of rporate Officer, Owner, or Designee
ox~„7Lf ~~ 6
Date
M:~PERMIIIMAST6RD000MENTSN9-AF-09