2003-01-13_REPORT - M1981107

• Permit No: M1981107
• IBM Index Class Name: Report
• Doc Date: 1/13/2003
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

12/27/2002 09
8022225831

PERMTITkE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY,DAT'E:
ANNUAL FEE DUE:
COUNTY:
ANNi1Ai. FF.R end REPORT RF,Q,IIF.ST
RECEIVED
ELB Stone, Inc.
M•i9gi•i07 JAN 132003
BusterQuerries etdiiovalsaadBeafogq
January 8, 2003
$688.00 (Due on or before your enntversary date)
Lsrimer
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 ~inual 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 daces for the beginning
of active operations, and the date active operations ceased for the year, if any.
Pl or ao~~ttarM ~.mir rrvicn.i vrittrn annual rnnnrt and annual rppt rLt IIfttit to fhic Farm. Please note tllllt nn
adequately labeled reap that clearly dtllncates and Includes the above dements may su~cc for a writtcn report.
Division records irx3icate the following permittee contact information. Please verify and make any. necessary
changes:
Permittee Contact: David )r. Buster
Permittee Name: ELB Stone, Inc.
Address: P.O. Box 42
Pbone Number:
Fax Number:
Fairlee , VT 05045
[phone]
[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.
.CJ
Si re f Corporide Officer, Owner, or Designee
U O
Dart:
M;WERMttN1ASTEgDOCUM:5N75HbAF-01