2010-10-12_REPORT - M1978066

• Permit No: M1978066
• IBM Index Class Name: REPORT
• Doc Date: 10/12/2010
• Doc Name: Annual Fee/Report/Map
• From: Rio Grande County
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REOUEST
1?
Rio Grande County
M-1978-066
10 Miles South Pit
October 22, 2010
$791.00 (Due on or before your anniversary date)
Rio Grande
12CE ED
OCT 12 2U10
Divlc;cn of Rocia?at;on,
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According--to _C.R.S.-34-32.5-1-1-6 or-C.R.S 34-32-4-16; -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 vour 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 necessary, then no new may 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.
I
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
Phone Number:
Fax Number:
If you
Monte Vista, CO 81144
[phone]
[phone]
ional comments and/or information that should be provided to the Division, please provide it
it to this form along with your written report and map. Annual Report instructions are
01
of Corporate Officer, Owner, or Designee
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Date
M:TERMIT\MASTERDOCUMENTS\NI-AF-04