REP00001 ‎(3)‎

411
ANNUAL REPORT
PERMITTEE NAME: Solberg Solberg & French
PERMIT NO.: M- 1981 -044
OPERATION NAME: Solberg Pit
ANNIVERSARY DATE: April 7, 2000
ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00
COUNTY: El Paso
PAID
According to C.R.S. 34- 32- 116(3)(x), 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 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 your revised annual report map and written report to this annual report. Please
mote that an adequately labeled ,map that clearly delineates and includes the above elements may
suffice for a written report.
Please type or print the current contact person's name, mailing address, and phone number in the space
provided:
Contact Name: Bob Solb
Address: 13745 Garrett Rd.
Falcon, CO 80831
Company: Solberg, Solberg 9 French
Phone No.: ( 719 )683 -3198
FAX No.: ( I119 )683 -3566
If there are additional comments and/or information that should be provided to the Division, please
provide it on a separate sheet and attach it to this report form along with your map and/or written
report.
Signature of Corporate Officer, t r
W TER M ITMASTERDOCUM ENTSW -AF -01
Date
INSTRUCTIONS ON BACK