2005-12-16_REPORT - M2000115

• Permit No: M2000115
• IBM Index Class Name: Report
• Doc Date: 12/16/2005
• Doc Name: Annual Fee/Report/Map
• From: Mullets Excavating LLC
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~~ ~
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
~ANN1iAi. FF.F, and REPORT RF.t1i1F,ST
~Mullett's Excavating, L.L.C.
M-2000-115
Mulletts Excavting Pit # 1
January 29, 2006
RECEIVED
~6EC 16 2~5
/ Division of Minerals and Geology
$688.00 (Due on or before your anniversary date)
Las Animas
According to C.R.S. 34-32.5-I 16 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 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 attac~ynnr revised written anneal rennrt and anmral re~nrt man to this form. Please reote that 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: Myron Mullett
Permittee Name: Mullett's Excavating, L.L.C.
Address: P.O. Box 322
Westcliffe, CO 81252-0322
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.
Sign Corporate Officer, Owner, or Designee
~~,-,-_ ~- v ,S
Date