REP40755

• Permit No: M1986140
• IBM Index Class Name: Report
• Doc Date: 3/15/2002
• Doc Name: 2002 Annual Report
• From: Universal Peat Sand and Gravel
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
RECEIVED
MAR f 5 2002
Division of Minerals and Geology
Universal Peat Sand and Gravel
M-1986-140
Wright Pit
April 13, 2002
$281.00 (Due on or before your anniversary date}
Park
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 [he annual fee, a report and map showing the extent of current disturbances to affected land,
--reclamation-accomplished-to-date-and-durtna-the-preceding year,-new-dis?urbances-[ha!-are anticipated-te eccu: -
during the upcoming year, reclamation that will be performed during the coming year, [he dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach vour revised written annual report and annual report map 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: R'„~ht
Permittee Name: Universal Peat Sand and Gravel
Address:
Phone Number:
P.O. Box 158
Jefferson, CO 80456
[phone]
Fax Number:

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If you have additional comments and/or information that should be provided to [he Division, please provide~it
below or attach it to this form~alon wi your written eport and map. Waal Report instruction~d~/ "" _
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Signature of Corpor to Officer or Owner
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Date ~ ~ ~ ~
M 9PERMITNIASTERD000MENTSN1-AF-01