2006-07-10_REPORT - M1998052

• Permit No: M1998052
• IBM Index Class Name: Report
• Doc Date: 7/10/2006
• Doc Name: Annual Fee/Report/Map
• From: Everist Materials LLC
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL PEE DUE:
COUNTY:
ANNiiAi FF.F and RFPORT RFt7iiFCT
Everlst Materials, LLC
/~ M-1998-052
Mascot Placer
July 22,2006
RECEIVED
~JU~ 10 2006
vDivision ~f Minerals and Geolor3y
$688.00 (I)ue on or before your anniversary date)
Summit
According.to.C.R.S. 34-32.-5-116 or C.R:S. 34=32=1 iG, each year, on the anniversary date of the permit, an operator
shall submit the annual fee, a report and map showing the extent of cun-ent 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 attach y~~ur revicerl written anneal reRnrt and anneal re nr,(Lt map to thic form The Annual Report
& Fee requirement is not met until we have received the following 3 components: fee, rennrt, and associated
maR (Afl 3 arc required regardless of the level of disturbance or absence of disturbance during the previous
year). Please mote that me adeg:catefy labeled map that clearly delineates and includes the above elerrrents may
se ff ce for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Greg Norwick
Permittee Name: Everlst Materials, LLC
Address: CF.PR.address 1
P.O. Box 1150
. -- ... -Silverthor.:e, ~O °0493- ^ -_ . .
Phone Number:
Fax Number:
[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.
Signature of rp rate Officer, Owner, or Designee
provided to the Division, please provide it
Annual Report instructions are enclosed.
71s l~l~ _ _
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