2003-10-09_REPORT - M1979192

• Permit No: M1979192
• IBM Index Class Name: Report
• Doc Date: 10/9/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNIJAT. FF.F, and RF.P(TRT RF.niIF.ST
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PERMITTEE NAME: Pete Lien and Sons, Inc. dba Trans Colorado ~crete
PERMIT NO.: M-1979-192 OC1 0 9 2003
OPERATION NAME: Spotted Burro Pit ~-,RdGeoto'
ptvision of ~.•
ANNIVERSARY DATE: October 14, 2003
ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date)
COUNTY: Fremont
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
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 ynnr revised written annual rennrt and anneal re nn rt m ~n 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:
Permittee Contact: Leda Craft
Permittee Name: Pete Lien and Sons,
Inc. dba Trans Colorado Concrete
Address: P.O. Box 767
Rapid City, SD 57709-0440
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.
t
Signature of Corp rate Officer, Owner, or Designee
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Date
M:~PERM IT VdASTERDOCUMENTSUA-AF-01