2005-08-10_REPORT - M1998022

• Permit No: M1998022
• IBM Index Class Name: Report
• Doc Date: 8/10/2005
• Doc Name: Annual Fee/Report/Map
• From: The Gallegos Corporation
• To: DMG
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
The Gallegos Corporation
I~M-1998-022
Conger Harvesting Area
June S, 2005
$281.00 (Due on or before your anniversary date)
Gunnison
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 year, new disturbances that are anticipated to occur
during the upcoming yeaz, reclamation that will be performed during the coming yeaz, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach ym~r revised written anneal rernrt and anneal re nn rt maw to thic form- Please note that 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:
Petmittee Contact: Robert M. Gallegos, Jr.
Permittee Name: The Gallegos Corporation
Address: P.O. Box 821 O
Vail, CO 81658
Phone Number: [phone]
Fax Number: [phone]
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 along with your written report and map. Amual Report instructions are enclosed.
Signature o Co~ ate Officer, Own r, r Designee
$ O
Date