2006-06-19_REPORT - M1990059

• Permit No: M1990059
• IBM Index Class Name: Report
• Doc Date: 6/19/2006
• Doc Name: Annual Fee/Report/Map
• From: Gil Moser
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Gil Moser
~M-1990-059
Eldorado-Pilot
May 21, 2006
RECEI~E~
JUN 191006
~1Waion of Minerah end Gealopy
$75.00 (Due on or before your anniversary date)
Ouray
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, 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'dtuitfg 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 vour revised written annual report and annual resort maa to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Gil Moser
Permittee Name: Gil Moser
Address: 705 Crestview Dr.
Farmington, NM 87401-9106
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 it to this form along with your written report and map. Annual Report instructions are enclosed.
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Signature of Corporate Officer or Owner
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Date
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