2004-08-24_REPORT - M1989077

• Permit No: M1989077
• IBM Index Class Name: Report
• Doc Date: 8/24/2004
• Doc Name: Annual Fee/Report/Map
• From: Colorado Alabaster Supply
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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REC~B@~~®
AUG 2 4 2004
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Colorado Alabaster Supply
M-1984-077
Colo Alabaster
August 28, 2004
Diviaivu of Minerals & GaoloBY
$75.00 (Due on or before your anniversary date)
Lorimer
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
Iand-reclamatiamaccamplished-tazlate-and-during-the-preceding~year, niwv-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 yeaz, if any.
Please atta~ynnr revised written anmral report and annnal re nrn t man to this form. Please Hole that an
adequately labeled rnap 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: Stanley C. Jones
Permittee Name: Colorado Alabaster Supply
Address: 1507 N. College Ave.
Ft Collins, CO 80524
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.
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Signature of Corporate Officer 'caner, or Designee
Ta3~o
Date
M:IPERMITNIASTERDOCUMENTS/M-AF-02.DOC