2005-06-16_REPORT - M1999040

• Permit No: M1999040
• IBM Index Class Name: Report
• Doc Date: 6/16/2005
• Doc Name: Annual Fee/Report Notice
• From: rio blanco county
• To: dmg
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Rio Blanco County[[,, ,,yy~~
M-1999-040 GU~~/
Red Wash Gravel Pit
May 17, 2005
RECEIif'E®
JUN 16 2005
Division of Minerals end Geology
$281.00 (Due on or before your anniversary date)
Rio Blanco
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_shalLsubmit-the-annual fee, a-report and=map-showing the extent of.current disturbances. to affected~__ -
~_ -land, reclamation accomplished fo 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 far the year, if any.
Please attach ynnr revised written anmral re~nr and annnal re nr m 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: derry-3teele^
Permittee Name: Rio Blanco County
Address: 570 2nd St.
Meeker, CO 81641
Phone Number: (970) 8~8=5b9i-
Fax Number: [phone]
ayi P. Mbrla~
fS78- gSgo
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.
e
ature of Corporate Of ice ,Owner, or Designee
~~~
Date
M:~PERMITUTASTERD000MENTSNI-AF-04