2004-02-03_REPORT - M1980248

• Permit No: M1980248
• IBM Index Class Name: Report
• Doc Date: 2/3/2004
• Doc Name: Annual Fee/Report/Map
• From: Moffat County
• To: DMG
• Media Type: D
• Archive: No

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PERMfi"fEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Moffat County
M-1980-248
Lyons Pit No 2
February 4, 2004
$688.00 (Due on or before your anniversary date)
Moffat
RECEIVE®
FEB 0 3 2004
Division of Minerals & Geology
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 sulzmit th~annual.fee~as'eport.andsvap shawin~the-.extcnLof_currentdisturbances-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 ylytr revised written annual report and annual re,Pnrf man 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: Billy E. Mack
Permittee Name: Moffat County
Address: P. O. Box 667
Craig, CO 81626
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.
STOCKPILE REDUCTION ONLY - NO P1AP NECESSARY
Signature orporate Officer, Owner, or Designee
January 7, 2004
Date
M:V'F.RMInMASTERD000MENTSNI-AF-04