2009-04-03_REPORT - M1981044

• Permit No: M1981044
• IBM Index Class Name: REPORT
• Doc Date: 4/3/2009
• Doc Name: Annual Fee/Report/Map
• From: Solberg Gravel LLC
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
_R P
A7AL FEE an REPORT REOUEST
lberg Gravel LLC
-1981-044
Solberg Pit
April 7, 2009
o/C
h yvt J?
ECE0
APR 0 3 2009
Divisiasf ai iKeclamation,
Mir, ng and Safety
$$791.00 (Due on or before your anniversary date)
El Paso
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 rep ceding 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 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 during the previous year and no new changes to
the previous vear's man are necessarv. then no new map is required, provided that the Operator shall state
this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the
above elements may suffice for a written report.
indicate the following permittee contact information
Bob Solberg
Solberg Gravel LLC
Address: 13745 Garrett Rd
Peyton, CO 80831
Division records
changes:
Permittee Contact;
Permittee Name:
Please verify and make any necessary
Phone Number: [phone]
Fax Nurlber: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
Signature of Corporate Officer, Owner, o es g ee
Date
below or attach it to t is form along with your written report and map. Annual Report instructions are enclosed.
I
r in