2010-10-29_REPORT - M1980143

• Permit No: M1980143
• IBM Index Class Name: REPORT
• Doc Date: 10/29/2010
• Doc Name: Annual Fee/Report/Map
• From: Neil's Excavation
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

A V-7 -t- e e-r
ANNUAL FEE and REPORT REQUEST .W
PERMITTEE NAME: `7NciPs Excavation 11
PERMIT NO.: //M-1980-143
OPERATION NAME: Texas Creek Gravel Pit ;
l
ANNIVERSARY DATE: October 27, 20•10
ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date)
COUNTY: La Plata
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 snap showing the extent of current disturbances to affected_land,_
reclamation- ecomptished-to date and-during fie 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 marl to this form The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
man. If no 'new disturbances or reclamation have occurred during the previous year and no new changes to
the previous year's man 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:
Pennittee Contact: Bruce E. Neil
Permittee Name: Neil's Excavation
Address: 486 CR 515
-- Ignacj5,,?O 81137
Phone Number:
Fax Number:
[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 tliic form along with your written report and map. Annual Report instructions are enclosed.
4 Z
Si?pi?ature of Corporate icer, Owner, or Designee
Date