2005-02-17_REPORT - M1995005

• Permit No: M1995005
• IBM Index Class Name: Report
• Doc Date: 2/17/2005
• Doc Name: Annual Fee/Report/Map
• From: Mountain Region Corporation
• To: DMG
• 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:
Mountain Region Corporation
M-1995-005
Orchard Mesa Aggr
February 16, 2005
FE3 ' < <:.i
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DiYisian ~f Minerals and Geology
$688,00 (Due on or before your anniversary date)
Mesa
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~o_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 ynnr revised written anmral rennrt and annual re~rt mwn to this fnrm_ 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 pennittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Sandra R. DuCray
Permittee Name: Mountain Region Corporation
Address: 117 - 29 3/4 Rd.
Grand Junction, CO 81503
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.
Signature of Corporate Offic weer, or Designee
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Date -~-