REP07384

• Permit No: M1981287
• IBM Index Class Name: Report
• Doc Date: 2/11/2005
• Doc Name: Annual Report and Fee
• From: DMG
• To: Nikolaus Arnusch
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

- •:
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Nikolaus Arnusch
M-1981-287
Arnusch Grav Pit 3
February 25, 2005
$281.00 (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,
re- ctatnal an-aocompfished-to-date-and-durin~the~receding_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 your reviced written annual report and annual report maw to this fnrm_ Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Nik Arnusch
Permittee Name: Nikolaus Amusch
Address: 34527 WCR 6
Keenesburg, CO 80643
Phone Number: [phone]
Fax Number:
^--~~f yo~ u-ial ve additiona commen s anZttor-information-that should be provided-to-the-Division, please provide_it_ _ ._ i
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
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Sig/n~atu-re of Corporate Offtcer, Owner, or Designee
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