2004-10-14_REPORT - M1979192

• Permit No: M1979192
• IBM Index Class Name: Report
• Doc Date: 10/14/2004
• Doc Name: Annual Report and Fee
• From: Pete Lien and Sons Inc. dba Trans Colorado Concrete
• 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:
Pete Lien and Sons, Inc. dba Trans Colorado Concrete
M-1979-192
Spotted Burro Pit
October 14, 2004
$688.00 (Due on or before your anniversary date)
Fremont
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 land,
'-- - reclamation accompli'shed` to-date xnd'during the preccedirig 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 ynnr reviced written anneal report and annual repnrf m to Chia fnrm_ please note that an
adequately jubejed 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: ~ ~ J~ r
Permittee Contact: Lecia Craft ~C(7rf 4-~n~q lJl~h
Permittee Name; Pete Lien and Sons, Inc. dba Trans Colorado Concrete
Address:
Phone Number:
Fax Number:
P.O. Box 767
Rapid City, SD 57709-0440
[phone]
[phone]
If you have additional comments and/or information that should be
below or attach it to this form along with your written report and map.
~~ ~ii l//iDnyn`
Signature of Corpo to Officer, Owne , or Designee
provided to the Division, please provide it
Annual Report instructions are enclosed.
/off/r~o~/
Date