2005-01-26_REPORT - M2000099

• Permit No: M2000099
• IBM Index Class Name: Report
• Doc Date: 1/26/2005
• Doc Name: Annual Fee/Report/Map
• From: Marilyn E. Vazquez Bruce A. Diamond
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Marilyn E. Vazquez, Bruce A. Diamond
M-2000-099
Pit Number One
February 9, 2005
$281.00 (Due on or before your anniversary date)
Chaffee
y
_ ~~
JAN 2 ~: [i;C5
r,.-
.-._ ....,tar-L_ _..Jo~t
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 accomp fished-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 yonr revised written anneal re~rt and annual re~-t m~ fn this form. Please note [hat 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: Marilyn E. Diamond
Permittee Name: Marilyn E. Vazquez, Bruce A. Diamond
Address: 26520 CR 301
Buena Vista, CO 81211
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 are enclosed.
V
Officer, Owner, or Designee

Date