2005-07-28_REPORT - M1999006

• Permit No: M1999006
• IBM Index Class Name: Report
• Doc Date: 7/28/2005
• Doc Name: Annual Fee/Report/Map
• From: sand land inc
• To: dmg
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
,.~
ANNTTAT. FF.F, and RF.P[)RT RF.OTiF.ST
Sand Land, Inc. ~~~
~/M-1999-006
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~UL 2 S 2005
Division of Niiaerals & GaoloAY
Kurtz Resource Recovery & Land Devlpmnt Proj
August 4, 2005
$688.00 (Due on or before your anniversary date)
Weld
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 yeaz, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach ysnlr revised written anmial re~nrf and annual re¢prt man 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: Christopher L. Varra
Permittee Name: Sand Land, Inc.
Address: 8120 Gage St.
Frederick, CO 80516
Phone Number: [phone]
Fax Number: (3) 666-6743
If you have additional comments and/or information that should be
below or attach it to this form along with your written report and map.
Signa a of Corporate Officer, Owner, or Designee
7- ~y_ 0~
provided to the Division, please provide it
Annual Report instructions are enclosed.
Date