2008-09-18_REPORT - M1977002HR

• Permit No: M1977002HR
• IBM Index Class Name: REPORT
• Doc Date: 9/18/2008
• Doc Name: Annual Fee/Report/Map
• From: Colorado Lien Company
• To: DRMS
• 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:
14 F
ANNUAL FE) and REPORT REQUEST
0 t4Ep 18 ZCW
Colorado Lien Company
Division or rceclamation,
41977-002-1111 Mining and Safety
Munroe Gypsum Quarry
September 16, 2008
$$791.00 (Due on or before your anniversary date)
Larimer
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 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 written annual report and annual report may to this form. The Annual Report & Fee
requirement is not met until we have received the following components: fee, report, and associated map. If no
new disturbances or reclamation have occurred during the previous year and no new changes to the previous
year's map are necessary, then no new map is required, provided that the Operator shall state this in the Annual
Report. Please note that an adequately labeled map that clearly delineates and includes the above elements may
suff ce for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary changes:
Permittee Contact:
Permittee Name:
Address
Mitch Nachtigall
Colorado Lien Company
P.O. Box 440
Rapid City, SD 57709
Phone Number: [phone]
Fax Number:
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
Date