2004-06-22_REPORT - M2000073

• Permit No: M2000073
• IBM Index Class Name: Report
• Doc Date: 6/22/2004
• Doc Name: Annual Fee/Report/Map
• From: Rio Blanco County
• 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:
Rio Blanco County
M-2000-073
Shults Gravel Pit
June 27, 2004
/~
~~~
RECEIVED
JUN ^c 2 2004
Division ai Minerals & Deology
$281.00 (Due on or before your anniversary date)
Rio Blauco
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 disturbanceslo,affect~d __
- -lands reclamaiionaccompiished-{o 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 atta~ymrr revised written annnal report and annnal re,Pnrt man 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: Jerry Steele
Petrnittee Name: Rio Blanco County
Address: 570 2nd 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 are
enclosed.
Signatur of Corpo e O facer, Owner, or Designee
S-lB-C3~f
Date
M:IPERMI7IMASTERD000MEN'1'S~hf-AF-04