2006-04-04_REPORT - M1994096

• Permit No: M1994096
• IBM Index Class Name: Report
• Doc Date: 4/4/2006
• Doc Name: Annual Fee/Report/Map
• From: High Plains Sand and Gravel LLC
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
/ANNTJAT. FF.F, and RF.Pt7RT RF.OTiF.RT
V High Plains Sand and Gravel, LLC
~/M-1994-096
Russell Gravel Pit
April 14, 2006
$688.00 (Due on or before your anniversary date)
Larimer
RECEIVED
~APR'0 42006
~vialan of Minera4 and 6ealopr
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
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 year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach yn~ r ced written anneal re~prt and anm~al repnH mare to this form. Please note thal 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: Robert Pittington Jr.
Permittee Name: High Plains Sand and Gravel, LLC
Address: P.O. Box 1228
Wellington, CO 80549
Phone Number: [phone]
Fax Number:
~1~-5th-`~~a-~
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.
Signatur of Corporate Officer, Owner, or Designee
2. ~ (~Q
/;.
Date