2002-03-18_REPORT - M1998034

• Permit No: M1998034
• IBM Index Class Name: Report
• Doc Date: 3/18/2002
• Doc Name: 2002 Annual Report
• From: Mountain Park Concrete Inc.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMffTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Mountain Park Concrete, Inc.
M-1998-034
Parshal Pit
March 17, 2002
$281.00 (Due on or before your anniversary date)
Grand
RECEIVED
MAR 18 2002
Division of Minerals and Geology
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,
"-' `-' rec amaTion accompri"sli~d`fo tiate arsd'during'fhe preceding-year; ~rew'disturbaiices-tiiai 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 resort and annual report map to this form. 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: M. Joe Docheff, III
Permittee Name: Mountain Park Concrete, Inc.
Address: P.O. Box 856
Granby, CO 80446
Phone Number: [phone]
Faz 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 [his form along with your written report and map. Annual Report instructions are enclosed.
ign re of orporate Of c r or Owner
~~/_l D~2
Date
M 1PERMnN9ASTERD000M ENTSU9-AF-01