REP18742

• Permit No: M1992102
• IBM Index Class Name: Report
• Doc Date: 2/23/2004
• Doc Name: Annual Fee/Report Notice
• From: Western Gravel Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNPJERSARY DATE:
ANNUAL FEE DUE:
COUN'T'Y:
Western Gravel, Iuc.
M-1992-102
South D-20 Pit
February 24, 2004
$688.00 (Due on or before your anniversary date)
Moutrose
RECEI~/E®
FEB 2 3 2004
Division of Minerals & GealoBY
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-submi±-the-annual-fee,-a -report-and_map_showing the_extent_o~current_disturbances_to_affected_land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming yeaz, 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 ymrr revised written anneal rennrt and anneal re~Qrt ma=tn this fnrm_ 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:
PermitteeContact: JudyDeVincentis
Permittee Name: Western Gravel, Inc.
Address: 3001 N. Townsend Ave.
Montrose, CO 81401
Phone Number: [phone]
Fax Number: [phone]
l~la~~c , G'fl, 8/1/d /
~9D~~f9~o~s'9D
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this farm along with your written report and map. Annual Report instructions aze enclosed.
Owner, or Designee
Date
M:~PERMIT~MASTERD000MENTS4M-AF-01