2002-01-23_REPORT - M1981004

• Permit No: M1981004
• IBM Index Class Name: Report
• Doc Date: 1/23/2002
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE/REPORT
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Dilleys Sand & Gravel
M-1981-004
Ayers Pit
JAN 2 3 2002
February 2, 2002 Division of Minerals and Ceolc
$281.00 (Due on or before your anniversary date)
Morgan

According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-I 16, 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,
reclmnation 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 your revised written annual report and annual report map to this form. Please more thnt an
adequnte[~~ lnGeled mnp tlrut clearly delineates and incur/es the above elenrenrs nrny since for n written report.
Division records indicate the following petmittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Vemon Dilley
Permittee Name: Dilleys Sand & Gravel
Address: 1914 Edmunds St.
Phone Number:
P.O. Box 125
Brush, CO 80723
[phone]
Fax Number: (9701 842-2284
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach i[ to this forni along with your written report and map. Annual Report instructions are enclosed.
,/ t
Signature of Corporate Office or Owner
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Date
M NERA7nN1A5TERD000MENr5N1-AF-01