2011-07-05_REPORT - M1976051

• Permit No: M1976051
• IBM Index Class Name: REPORT
• Doc Date: 7/5/2011
• From: Duckels Construction, Inc.
• 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:
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 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 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: Fred A. Duckels
Permittee Name: Duckels Construction, Inc.
Address: 3500 Duckels Court
Steamboat Springs, CO 80487
Phone Number: (970) 879 -6072
Fax Number: (970) 879 -6748
Signature of
Date
orate Offic
r Designee
ANNUAL FEE and REPORT REQUEST
✓ Duckels Construction, Inc.
M- 1976 -051
Bettger Gravel Pit
May 8,2011
$791.00 (Due on or before your anniversary date)
Routt
RECE
" JUL 05 2011
Division of Reclamation,
Mining and Safety
RECEIVED
Q
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Jug_ 5 '
Division of Roatam an
Mining & Safety
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.