2010-03-11_REPORT - M1987019

• Permit No: M1987019
• IBM Index Class Name: REPORT
• Doc Date: 3/11/2010
• Doc Name: Annual Fee/Report/Map
• From: Rio Grande County
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

A;:. I RPM
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REOUEST
? Rio Grande County
M-1987-019
South Fork Pit
March 25, 2010
r1iF? ?? .?0?0
y 91wolon of Reclamation,
v Mining & Safety
$323.00 (Due on or before your anniversary date)
Rio Grande
- - -- According-to-C.-R-. S. 34-32.5-116-or -C-R.S. 34-32-1-1-6,- 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 may. 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 suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Patrick Sullivan
Permittee Name: Rio Grande County
Address: 168 N. Washington
Monte Vista, CO 81144
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
bel or atta it to this form along with your written report and map. Annual Report instructions are
e closed.
ignature of Corporate Officer, Owner, or Designee
Date
M: PERMITIMASTERDOCUMENTS\N4-AF-04