REP07800

• Permit No: M1977136
• IBM Index Class Name: Report
• Doc Date: 2/12/2004
• Doc Name: Annual Fee/Report Notice
• From: Rio Blanco County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

,v - o i~
,V RECEIVED
FEB 12 2004
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Division of Minerals & Geology
Rio Blanco County
M-1977-136
Prather Pit
February 23, 2004
$688.00 (Due on ar 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
-opzratorshalt-submit-the-armual fce,-a-report-and map-shawirg-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 anneal re~Drt and anmral renort malLtn this form. 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: Jeny Steele
Permittee Name: Rio Blanco County
Address: 570 Second St.
Meeker, CO 81641
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 aze
enclosed.
Signature of Corporate O ficer, Owner, or Designee
Date

M:~PERMI'I\MASTERIbCUMENTS~M-AF-0O