2005-06-29_REPORT - M1997071

• Permit No: M1997071
• IBM Index Class Name: Report
• Doc Date: 6/29/2005
• Doc Name: Annual Fee/Report/Map
• From: william and beverly caldwell and alber and lola nesselhuf
• To: dmg
• Media Type: D
• Archive: No

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RECEIVE®
ANNiTAf, FF.F, and REPORT RF,t7iiF.ST
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PERMITTEE NAME: William & Beverly Caldwell and Albert & Lola es~~i~llnerala and Geology
PERMIT NO.: M-1997-071
OPERATION NAME: Caldwell-Nesselhuf Pit No. 1
ANNNERSARY DATE: June 30, 2005
ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date}
COUNTY: Crowley
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 I
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 I
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 ynnr revised written annual re~nrf and anneal re,Pnrt maw to this 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:
Permittee Contact: Albert F. Nesselhuf, Jr.
Permittee Name: William & Beverly
Caldwell and Albert & Lola Nesselhuf
Address: 31738 Rd 13
Manzanola, CO 81058-0
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.
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