2006-06-01_REPORT - M1999120

• Permit No: M1999120
• IBM Index Class Name: Report
• Doc Date: 6/1/2006
• Doc Name: Annual Fee/Report/Map
• From: L.G. Everist Inc.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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RECEIVED
JUiJ 0 t' 2006
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
L.G. Everist, Inc.
M-1999-120
Ft. Lupton Sand and Gravel Mine
June 1, 2006
$688.00 (Due on or before your anniversary date)
Weld
Division of Minerals and Geology
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 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 far the year, if any.
Please attach ynnr revised written annnal re~nrt and annnal re nn rt main 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 pennittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Lynn Mayer J hd (TS
Permittee Name: L.G. Everist, Inc.
Address: 7321 E. 88th Ave. Ste. 200
Henderson, CO 80640
L~ ~n N1 ~~ SllvlfS
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 aze enclosed.
Officer, ter, or Designee
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Date