2005-05-11_REPORT - M1994121

• Permit No: M1994121
• IBM Index Class Name: Report
• Doc Date: 5/11/2005
• Doc Name: Annual Fee/Report/Map
• From: Lucio Vasquez
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Lucio Vasquez
M-1994-121
Vasquez Quarry No 2
April 13, 2005
$281.00 (Due on or before your anniversary date)
Boulder

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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_lan_d,__
- ree!amation accomplished to date-and during the preceding year; "new disturbances`that are ari'hcipaYed 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 ym~r revised written annual report and anneal report map 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: Lucio Vasquez
Permittee Name: Lucio Vasquez
Address:
Phone Number:
- -Fax Number:
Erie, CO 80516
2425 I-25 W. Frontage Rd.
[phone]
[phone]
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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 Offic r, Owner, or Designee
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Date