2010-08-25_REPORT - M2002068

• Permit No: M2002068
• IBM Index Class Name: REPORT
• Doc Date: 8/25/2010
• Doc Name: Annual Fee/Report/Map
• From: Rick Ensminger
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Rick Ensminger
M-2002-068
Ensminger Pit
July 29, 2010
$$323.00 (Due on or before your anniversary date)
Phillips
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 man 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 near and no new chanzes to
the previous vear'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: Rick Ensminger
Pennittee Name:
Address:
Phone Number:
Fax Number:
Rick Ensminger
P.O. Box 276 _
3500 Hwy. 6 _
Haxtun, CO 80731
[phone]
[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.
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4
Signature of Corporate Officer, , or Designee
Date