REP52195

• Permit No: M1978002
• IBM Index Class Name: Report
• Doc Date: 2/12/2004
• Doc Name: Annual Fee/Report Notice
• From: Rio Blanco County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

n1- o /G

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Rio Blanco County
M-1978-002
Texas Creek Pit
February 23,2004
$281.00 (Due on or before your anniversary date)
Rio Blanco
RECEIVE
FEB 12 2004
Division of Minerals & Geotopp
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~b_m~thP anal fer a repnriand:znapskurwing~tlte:ca~tgnt~sa~rrent-ctist«bo,=e~, :3-~sf€eeted
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 attacj4ynnr revised written annual report and annnal re nn rt map 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: Ron Leeper
Permittee Name: Rio Blanco County
Address: 570 2nd St.
Meeker, CO 81641
--Phone-Number:-> (970) 878=5601-- -----
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.
Signature of Corporate Officer, Owner, or Designee
~ - i `~. - ry
Date
M:~PERMI71hfAS7ERD000MENTS~M-AF-04