2003-07-14_REPORT - M1991147

• Permit No: M1991147
• IBM Index Class Name: Report
• Doc Date: 7/14/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Stoue Forge
M-1991-147
Quinn Quarry
July 16, 2003
$281.00 (Due on or before your anniversary date)
Douglas
JUL 1 4 2003
Division of Minerals and GealatlY
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 land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
driringthe up~oming~ear; r~ctamation that will-be-p~rformed daring-the canritrgyear,-the dates-for the beginning --
of active operations, and the date active operations ceased for the year, if any.
Please attach ymrr revised written anneal rennrt and anneal reRprt man to this form- Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffrce for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Jack G. Quinn
Permittee Name: Stone Forge
Address: 620 W Henrietta Ave.
P. O. Box 155
Woodland Park, CO 80866
Phone Number: [phone]
ax um er:
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.
~?~~. .~,
Signature of Corporate Officer, Owner, or Designee
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Date
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M:\PERMITMASTERDUCUMENTS\M-AF-01