2005-08-17_REPORT - M1986105

• Permit No: M1986105
• IBM Index Class Name: Report
• Doc Date: 8/17/2005
• Doc Name: Annual Fee/Report/Map
• From: Dilleys Sand & Gravel
• To: DMG
• Media Type: D
• Archive: No

o~V~S
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
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D//illeys Sand & Gravel ~~~
"M-1986-105
Vondy Pit
August 29, 2005
]~7 AUG 17 2005
I v Division oP li;ii,,;mis & Szola~y
$281.00 (Due on or before your anniversary date)
Morgan
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 amanon accompns a o a e an unng a prec amg a a, ~ -to-actor -
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 ym~r revised written anmial renurt and annual re,Pnrf m ~n to this form- Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Vemon Dilley
Permittee Name: Dilleys Sand & Gravel
Address: 1914 Edmunds St.
P.O. Box 125
Phone Number:
Fax Number:
Bmsh, CO 80723
[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 this form along with your written report and map. Annual Report instmctions are enclosed.
Si afore of Corporate Officer, Owner, r Designee
-/~- o s
Date