2010-01-14_REPORT - M2000115

• Permit No: M2000115
• IBM Index Class Name: REPORT
• Doc Date: 1/14/2010
• Doc Name: Annual Fee/Report/Map
• From: Mullett Excavating
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Email Name: JLE
• Media Type: D
• Archive: No

0)----
'A le
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
I
AM?IAL FEE add P T REQUEST
Z Z lett Excavating, LLC
fi1VI-2000-115
Mulletts Excavting Pit # 1
January 29, 2010
$$791.00 (Due on or before your
Las Animas
?CE11/ED
AN 14 2910
Mft & sat*
-T't/
date)
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 Curren disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturban es that are anticipated to occur
during the upcoming year, reclamation that will be performed-during the coming ear, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
& Fee requirement is not met until we have received the following
map. If no new disturbances or reclamation have occurred during 1
this in the Annual Report. Please note that an adequately labeled map that
above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please
changes:
Permittee Contact: Myron Mullett
Permittee Name: Mullett Excavating, LLC
Address: P O Box 322
320 CR 241
Westcliffe, CO 81252
Phone Number: [phone]
Fax Number: [phone]
The Annual Report
delineates and includes the
ify and make any necessary
If you have additional comments and/or information that should be provided
below or attach it to this form along with your writte report and map. Annual R
Signature of Corporate Officer, Owner,
the Division, please provide it
port instructions are enclosed.
12- /v-o
Date