2001-04-23_REPORT - M1989065

• Permit No: M1989065
• IBM Index Class Name: Report
• Doc Date: 4/23/2001
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Centennial Materials, Ioc.
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M-1989-065 APR 2 3
Winkler Light Aggregate Quarry 2001
Division of Minerals and Ceelogy
April 26, 2001
$688.00 (Due on or before your anniversary date)
Douglas
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 dismrbances 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 vour revised written annual resort and annual report map to this form. Please note that an
adequately lnbeled map shat 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: Donald L. Opheim
Permittee Name: Centennial Materials, Inc.
Address: 1101 Topeka Wy.
Castle Rock, CO 80104
Phone 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 [his form along with your written report and map. Annual Report instructions are
enclosed.
0
Signature of Corporate Office or Owner
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Date
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