2001-05-21_REPORT - M1990025

• Permit No: M1990025
• IBM Index Class Name: Report
• Doc Date: 5/21/2001
• 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: Four States Aggregates, LLC RECEI ~~~
PERMIT NO.: M-1990-025 MAY 2 1 2001
OPERATION NAME: Gardner Pit No 2a Division of Minerals and Geology
ANNIVERSARY DATE: May 22, 2001
ANNUAL FEE DUE: $550.00 (Due o0 or before your anniversary date)
COUNTY: Montezuma
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, ne~v 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 mote thnt nrt
adegrratefy labeled map that clearly delineates ar:d includes the above elements may sr ffice for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Aryol Brumley
Permittee Name: Four States Aggregates, LLC
Address: P.O. Box 1568
Cortez, CO 81321-1568
Phone Number: [phone]
Fax Number: ~~'j~~ 5l`p`J' - ~~57
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.
u of o ora e I or caner
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Date
M'~PERM ITUtASTERDOCUMENT5NI-AF-01