2005-09-12_REPORT - M1991086

• Permit No: M1991086
• IBM Index Class Name: Report
• Doc Date: 9/12/2005
• Doc Name: Annual Fee/Report/Map
• From: Bent County
• To: DMG
• Media Type: D
• Archive: No

~~=rPi I!o

PERMITTEE NAME: Bent County ~ Y~ ~ r ~ ~ ~ ~
PERMIT NO
: rl~I-1991-086
. SEp ~ 2 2005
OPERATION NAME: Earl-Hoffman-Reyher

ANNIVERSARY DATE:
October 3, 2005 /~,
!(.Division of Mine~ms and Geology
ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date)
COUNTY: Bent
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 for the year, if any.
Please attach ynnr revised written annnal rennrt and anm~al rennrt mad to this form- Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Gary Pritchard
Permittee Name:
Address:
Bent County
P.O. Box 350
Las Animas, CO 81054-0350
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.
e' r
Stgnatty~ of Corporat Officer, Owner, o Destgnee
o9-oy-moos
Date
M:~PERMITMASI'ERDOCUbffiNTS1M-AF-04