2009-01-27_REPORT - M1977153

• Permit No: M1977153
• IBM Index Class Name: REPORT
• Doc Date: 1/27/2009
• Doc Name: Annual Fee/Report/Map
• From: Denver Water Dept
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Email Name: DB2
• Media Type: D
• Archive: No

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ANNUAL FEE at REPORT REOUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
A?Zt n ver Water Department
M-1977-153
Reclamation Pit No 1
February 7, 2009
$5791.00 (Due on or before your anniversary date)
Adams
/jg4 2 7 2009
iviSion ofaReclamation,
Mining
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 map 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 vear and no new chances to
the previous vear's map are necessarv, 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 suffice for a tivritten report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: John H. Bambei, Jr
Permittee Name: Denver Water Department
Address: 1600 W. 12th Ave.
Denver, CO 80204
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.
Sta ure of Corpo e Officer, Owner, or Designee
/_23_09
Date