2003-09-05_REPORT - M1991104

• Permit No: M1991104
• IBM Index Class Name: Report
• Doc Date: 9/5/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECEIVED
SEP 0 5 2003
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNPJERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Gunnison County
M-1991-104
Nicolas Pit
September 17, 2003
$281.00 (Due on or before your anniversary date)
Gunnison
Dirision ~t Minerals and Geology
__,According_to_C.R.S._34,32.5=1.16_or C.R.S.-34-32..116,_each-year,-on-the anniversary-date=of-the-permiE; an---
-operator shall_submit_the_annual_fee, areport and map showing_the_extent of_current disturbances to.affec[ed _
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 ynnr revised written annnal rennrt and annual rennrt ma,~n to this fnrm_ Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Marlene Crosby
Permittee Name: Gunnison County
Address: 811 Rio Grande
Gunnison, CO 81230
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.
~gnature of Corporate Officer, Own r Designee
~L~ oC fi ~t7f~3
Da[~
M:\PERMnIMASTERDOCUMENTSU-I-AF-04