REP12525

• Permit No: M1981086
• IBM Index Class Name: Report
• Doc Date: 7/3/2002
• Doc Name: 2002 Annual Report
• From: N Colo Water Conservancy Dist
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
N Colo Water Conservancy Dist
M-1981-086
Borrow Area C
July 21, 2002
$688.00 (Due on or before your anniversary date)
Grand
JUL Q 3 pQ02
Division of Minerals and Geology .
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
operatorshall-submit-tfie-armual-fee,-a-report and-map-showing-the-extent-of-current disturbances tc-affected-
land, reclamation accomplished to date and during the preceding year, new disturbances that aze 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 your revised written annual renort and annual report map to 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 A. Westbrook
Permittee Name: N Colo Water Conservancy Dist
Address: P.O. Box 679
Loveland, CO 80539
Phoue 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.
t to v~ f rate Officer or r
Z O
Date
M:tPERMI"RMASTERDOCUMENTSVvr-AF-04