2011-03-14_REPORT - M1990148

• Permit No: M1990148
• IBM Index Class Name: REPORT
• Doc Date: 3/14/2011
• Doc Name: Annual Fee/Report/Map
• From: Kiowa County
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

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PERMITTRE NAME:
PERMIT NO.:
OPERATION NAME:
ANNTVEKSARY DATE,:
ANNUAL FEE DUE:
COUNTY:
9qq&-1
AN A . FEE and e,4?U REQUEST
own County
M-1990-148
Gray Pit
RECEIV90
I/
MAR 14 2011
Ivtsion of Reclamation,
Mining and Safety
February 5, 2011
$$323.00 (Due on or before your anniversary date)
Kiowa
According to C.K.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 ?nap 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 our revised written annual report and annual report ma 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 durin the revious ear and no
new changes to the previous ear's ma are necessary, then no new ma is required, Provided that the
Operator shall state this in the Annual Report. Please rote that an adequalely laheled map that clearly
delineates and includes the above elements nray vuffiee for a written report
Division records indicate the following permittee contact information, Please verify and make any necessary
changes.
Permittee Contact: Rick Spady
Permittee Name: Kiowa County
Address: P.O. Box 100
Eads, CO 81036
Phone Number: [phone]
Fax Number: [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,
ignature of orpor Officer, Owner, or Designee
Date
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