REP31504

• Permit No: M1998103
• IBM Index Class Name: Report
• Doc Date: 4/4/2003
• Doc Name: Annual Report
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~~ RECE',~ED
PERMITTEE NAME:
PERMIT NO,:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Homer Monks Construction, Inc.
M-1998-103
Patty's Pit
April 10, 2003
$281.00 (Due on or before your anniversary date)
Elbert
APR 0 4 2G~3
(i{vision of Minerals and Geele@y
According [o 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 m_ap 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 year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual re~prt and anmial reTurf ma~tn 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: Patty L. Monks
Permittee Name: Homer Monks Construction, Inc.
Address: P.O. Box 1207
Limon, CO 80828
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.
Signature of C or to Officer, Owner, or Designee
April 3, 2003
Date
M:NERMITUTASTERD000M ENTSUI-AF-01