2006-07-05_REPORT - M1986074

• Permit No: M1986074
• IBM Index Class Name: Report
• Doc Date: 7/5/2006
• Doc Name: Annual Fee/Report/Map
• From: DMG
• To: Kym A. Schure
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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~ANNTiAT, FFF, and RF.PTIRT REOTTFST
PERMITTEE NAME: vK/ym A. Schure
PERMIT NO.: t/I~I-1986-074
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Dollerschell Pit
June 30, 2006
RECEIVED
//1UL 0 5 2006
t/ pivisian of Minerals and Geology
$281.00 (Due on or before your anniversary date)
Logan
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,
reclamatiorc-atconiplished-tozlarte=and'c"lu'ring the'peeceding'year; new distwbances~fiat are anncipate"d ~o 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 ~nur revised written annual report and anneal report map~n 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: Kym A. Schure
Permittee Name: Kym A. Schure
Address: 12826 CR 37
Sterling, CO 80751
Phone Number: , _ [phone] _
Fax Number:
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,
- - --- ~ ~J
Si afore of Corporate Officer, Owner, or Designee
~ ;tea ro.G
Date