2005-06-13_REPORT - M2002046

• Permit No: M2002046
• IBM Index Class Name: Report
• Doc Date: 6/13/2005
• Doc Name: Annual Fee/Report Notice
• From: ephemeral resources llc
• To: dmg
• Media Type: D
• Archive: No

~~
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
AIVNLIAL FEE DUE:
COUNTY:
Ephemeral Resources, LLC
M-2002-046 q ~'
D Road Gravel Pit
Apri114, 2005
JUN 1 31005
flivisian of Minerals and Geology
$688.00 (Due on or before your anniversary date)
Mesa
N~
According to C.R.S. 34-32.5-1 l6 or C.R.S. 34-32-I I6, 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,
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 ymm revised written annnal rennrt and annual repQ~man to t~ h9¢ 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: Mark Gardner
Permittee Name: Ephemeral Resources, LLC
Address: 1225 S. 7th St.
Grand Junction, CO 81501
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments andlor 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.
Signature of Cotpotate Officer, Owner, or Designee
Harold F. Elam, Manager
/~3. ~ o a ,S- -
Date