2006-12-14_REPORT - M1996049

• Permit No: M1996049
• IBM Index Class Name: Report
• Doc Date: 12/14/2006
• Doc Name: Annual Fee/Report/Map
• From: Everist Materials, LLC
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME: +~ANNUAL FEE and REPORT REQUEST
/~erist Materials, LLC
'~ M-1996-049
Maryland Creek Ranch ~~~~~~~~~
M DEC 14
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ANNNERSARY DATE: December 20, 2006
ANNUAL FEE DUE: $$688.00 (Due on or before your anniversary date)
COUNTY: Summit
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12-1-~-~
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_yeaz, new disturbances that_aze_anticipatedto.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 your revised written annual report and annual report map to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
map. If no new disturbances or reclamation have occurred durinc the previous year and no new chances to
the previous Year's map are necessary, then no new map is required, provided that the Operator shalt state
this in the Annual Report. Please note that an adequately Zabeled 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: Greg Norwick
Permittee Name: Everist Materials, LLC
Address: P.O. Box 1150
Silverthorne, CO 80498
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 Repor[ instructions are enclosed.
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Signatur f orporate Officer, Owner, or Designee
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Date