2009-08-31_REPORT - M1977546

• Permit No: M1977546
• IBM Index Class Name: REPORT
• Doc Date: 8/31/2009
• Doc Name: Annual Fee/Report/Map
• From: Brice F & Phyllis J Lee
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

r) Or
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REODUEST
Brice F Lee & Phyllis J Lee ?
M-1977-546
Horvath Pit No 1
July 26, 2009
$323.00 (Due on or before your anniversary date)
La Plata
RECEI"D
v AUG 3 12009
Diwsion or ?- cl_
Minin arnatiow,
9 and Safety
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-d sturbances-that-are-anticipated-to-ozcur
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 year and no new changes to
the previous year'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 since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Brice F. Lee
Permittee Name: Brice F Lee & Phyllis J Lee
Address: 940 CR 119
Hesperus, CO 81326
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that ould be provided to the Division, please provide it
below or att it to this form along with your written r ort and map. Annual Report instructions are enclosed.
igna of Corporate Of icer, Owner, or Designee
Date