2004-04-22_REPORT - M1981235

• Permit No: M1981235
• IBM Index Class Name: Report
• Doc Date: 4/22/2004
• Doc Name: Annual Fee/Report/Map
• From: Webster Sand & Gravel
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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RECEI\~~':
APR 2 22004
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Webster Sand & Gravel
M-1981-235
West Tennessee
April 22, 2004
OiYtsion of Minerals en,: ,, __„
$688.00 (Due on or before your anniversary date)
Lake
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 yeaz, new disturbances that are anticipated to occur
during the upcoming yeaz, 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.
Ptease attach ynnr revised written annual rennr[ and annual report main to this fnrm_ Please note that an
adequately labeled map that clearly delieteates and includes the above elements may since for a wr[t[en report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Charles J. Webster
Permittee Name: Webster Sand & Gravel
Address: 145 S. Toledo Ave.
Leadville, CO 80461
Phone Number: [phone]
Fax Number: [phone]
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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.
V 'L~
S-i -tu f Corporate Officer, Owner, or Designee
Date A~~ /Qfj00~

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