REP31875

• Permit No: M1981044
• IBM Index Class Name: Report
• Doc Date: 4/3/2003
• Doc Name: Annual Report
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Solberg Gravel LLC
M-1981-044
Solberg Pit
April 7, 2003
APR 0 3 2003
Division ~f Minerals and Gealegy
$688.00 (Due on or before your anniversary date)
EI Paso
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
sfiall submit-the annual`fee;~a-report-and-map-showing-the-extent-o~eurrent-disturbances-to-affected-_Iand,
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 ymrr revised written annual rennrf and anneal report maw to this form. Please note 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: Bob Solberg
Permittee Name:
Address:
Phone Number:
Fax Number:
Solberg Gravel LLC
13745 Garrett Rd.
Falcon, CO 80831
[phone]
[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.
J
Signature of orporataae O fire , O er, or Designee
C/
Date
M:~PERMI'M4ASTERD000MENTSVd-AF-01