2005-09-09_REPORT - M1977301

• Permit No: M1977301
• IBM Index Class Name: Report
• Doc Date: 9/9/2005
• Doc Name: Annual Fee/Report/Map
• From: Colorado Lien Company
• To: DMG
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
C/olorado Lien Company Jam'
,/M-1977-301
Roberts Quarry
September 22, 2005
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Division of y,;.
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$688.00 (Due on or before your anniversary date)
Lorimer
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
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 ynnr revised written anm~al rennrt and annnal report maw 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: Lecia Craft
Permittee Name: Colorado Lien Company
Address: P.O. Box 767
Rapid City, SD 57709
-Phone Number:,(605).342_7224 _
Fax Number:
~he~\y E~~cK~u^~
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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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Signature of orporate Officer, Owner, or Designee
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Date