2003-12-15_REPORT - M2000092

• Permit No: M2000092
• IBM Index Class Name: Report
• Doc Date: 12/15/2003
• Doc Name: Annual Fee/Report Notice
• From: City of Walsenburg
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
City of Walsenburg
M-2000-092
Walsenburg Gravel Pit
December 14, 2003
DEC 7 5 2003
®tgi3ion of Minerals antl Geolon~-
$281.00 (Due on or before your anniversary date)
Huerfano
_ _ Accordi_ng_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 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 ynnr revised written annual rennrt and annual rennH ma= to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since jor a written
report.
Division records indicate the Following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Maurice Beau
Permittee Name: City of Walsenburg
Address: 525 S. Albert
Walsenburg, CO 81089
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 Officer, Owner, or Designee
%~ ~2-03
Date
M:~PERM ITUTASTER DOCUMENTSVvI-AF-04