2006-03-14_REPORT - M2003021

• Permit No: M2003021
• IBM Index Class Name: Report
• Doc Date: 3/14/2006
• Doc Name: Annual Fee/Report/Map
• From: Ranch Land LLC
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMtITEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
~ Ranch Land LLC
/M-2003-021
Ranch Land Rock Pit #2
March 22, 2006
/t'fa.., t.
1ir~p~ atMlserela and Geology
$688.00 (Due on or before your anniversary date)
Fremont
According to C.R.S. 34-32.5-I 16 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,
Teclaivatiori 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 c':ates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach~p~ revise 1 written anm.a( report and annual report map to chic form. Please note that an
adeyuately labeled Wrap that clear•fy delineates and includes the above elements may snJJice for a written report.
Division records indicate the following petmittee contact information. Please verify and make any necessary
changes:
Permittee Contact: William }'eeta
Permittee Name: Ranch Land LLC
Address: 3925 I}ill Circle
Colorado Springs, CO 80904
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 }t to this form along with your written report and map. Annual Report instructions are enclosed.
%['C IY~t~.+.~~/ ~ 2 ~~Yirl~tr / S ir-a~ ~ t d ern L
Signature f orporate Ofticer, Owner, or Designee
3/i3/a~
Date