2006-09-14_REPORT - M1995038

• Permit No: M1995038
• IBM Index Class Name: Report
• Doc Date: 9/14/2006
• Doc Name: Annual Fee/Report/Map
• From: Haldorson and Sons 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:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
/Haldorson and Sons, Inc.
f~~M-1995-038
r/ Spor Pit
October 30, 2006
F~E~~FIV~,i~
/ SF.P 1 4 2006
t/f?ivicion of Reclamation,
iKbr~N~' u~7e .~drody
$281.00 (Due on or before your anniversary date)
San Miguel
~I~
q 2 /~
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 ma~showinc 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 vour revised written annual report and annual report maa to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
man. If no new disturbances or reclamation have occurred durinc the previous veer and no new chances to
the previous year's map are necessary, then no new man is required, provided that the Ouerator shall state
this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the
above elements may since far a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Mark S. Haldorson
Permittee Name: Haldorson and Sons, Inc.
Address: P.O. Box 1019
Montrose, CO 81402
Phone Number: [phone]
Fax Number:
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If you have additional comments and/or information that should be provided to the Division, please provide it
below or a~ttac~h it/to this form along with your written report and map. Annual Report instructions are enclosed.
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Signature of orporate Officer, Owner, or Designee
9-ice ~7`
Date