REP04959

• Permit No: M1993050
• IBM Index Class Name: Report
• Doc Date: 1/15/2004
• Doc Name: 2004 Annual Report
• From: Raymond F. & Robert W. Dellacroc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMTI' NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Raymond F. & Robert W. Dellacroc
M-1993-050
Dellacroce Pit
February 22, 2004
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$688.00 (Due on or before your anniversary date)
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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,
reclama loci a . -preeediag~re„ ,-~..-~a~*lrbances_that_arE ~nr;~;natedsa 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 annual report and annnal re,Pnrt mad 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: Joe Kraig
Permittee Name: Raymond F. & Robert W. Dellacroc
Address: Pioneer Sand Co., Inc.
P. O. Box 7650
Colorado Springs, CO 80903
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be
below or attach it to this farm along with your written report and map.
c
Signature of o orate Officer, Owner, or Designee
1/2/~ ~
Date
provided to the Division, please provide it
Annual Report instructions are enclosed.
M:~PERMITMASTERDOCUMENTS4M-AF-Ol