2006-08-09_REPORT - M1999076

• Permit No: M1999076
• IBM Index Class Name: Report
• Doc Date: 8/9/2006
• Doc Name: Annual Fee/Report/Map
• From: Elam Construction Inc
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
1~ANNUAL FEE and REPORT REQUEST
t~ Elam Construction, Inc.
/M-1999-076
Highway 50 Borrow Area No. 2
August 5, 2006
RECEIVED
~/ AUG 0 9 2006
t/Drvision of Reclamation,
Mining and Safety
$438.00 (Due on or before your anniversary date)
Mesa
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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 i
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reclamatiorraccotnptisht;d-to-date-and-ding-the-preceding-year,-r:,w-disharbances-that-are-anticipated-to occur -L
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 report and annual report map to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated ~,
man (All are required regardless of the level of disturbance or absence of disturbance during the previous ~
year). Please note that an adequately labeled map that clearly delineates and includes the above elements may i
since for a written report.
Division records indicate. the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Harold F. Elam
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Permittee Name: Elam Construction, Inc.
Address: 1225 S. 7th St.
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Grand Junction, CO 81501
- 1
Phone Number: [phone]
Fax Number: [phone]
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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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igna • f Corporate O cer, Owner, or Designee
?S - .S - cv
Date