2005-08-31_REPORT - M1982141

• Permit No: M1982141
• IBM Index Class Name: Report
• Doc Date: 8/31/2005
• Doc Name: Annual Fee/Report/Map
• From: Moffat Limestone Company
• To: DMG
• Media Type: D
• Archive: No

/~~ ~ ~P~
~ rs
~~/Q. ~'~P QYn
AUG 3 1 20Q5
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE;
ANNUAL FEE DUE:
COUNTY:
Moffat Limestone Company
~-1982-141
Juniper Quarry
August 9, 2005
Oivisicr. ai r.~i.._:.is @ Geology
$550.00 (Due on or before your anniversary date)
Moffat
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,
rec ama t~plished-to da a an unng a prece mg year, new ~siurbances that ate anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates far the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach ynnr revised written anm~al report and annual reRrf man to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice far a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Don Steele
Permittee Name: Moffat Limestone Company
Address:
Phone Number:
Fax Number:
60765 US Hwy 40
P.O. Box 37
Maybell, CO 81640
[phone]
[phone]
.7lartrcyL sr~~c~
MGPFAr L1Me5TeNG `,e.
G ~. ~a~ us• MwY 'f~
P-D. 13a,t ~ oS
/yJ ~~ 6 a LL , Ca . S/G ~1U
X70 -a~~.-3~•/s
y~o- ~~2-s~~s
If yeu 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.
~ • t~Re $ ! o%Nf
Signature Corporate Officer, Owner, or Designee
gag a5-
Date