2001-02-12_REPORT - M1990131

• Permit No: M1990131
• IBM Index Class Name: Report
• Doc Date: 2/12/2001
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST RECEIVED
PERMITTEE NAME: Wayne A & Jerry A Mitchell FEB 12 2001
PERMIT NO.: M-1990-131 Division of Minerals and G,,v;py
OPERATION NAME: Mitchell Pit No 2
ANNIVERSARY DATE: February 14,2001
ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date)
COUNTY: Adams
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-fec,.a reportand-map.s_howing the extent of curerit 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 your revised written annual report and annual report man to this form. Please mote that an
.adequately labeled map that clearly delineates and includes the above elements may suffice for a written
report.
Division records indicate the following pennittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Wayne Mitchell
Permittee Name: Wayne A & Jerry A Mitchell
Address: P.O. Box 267
Bennett, CO 80102
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.
Signatur of Corporate Officer or Owner
.X&O/o /
Date
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