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~; - ~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COiJN"I'Y: <br />~~~~~ <br />'~/M/offat County <br />~I-1978-007 <br />Big Buru Pit No 17 <br />February 23,2007 <br />~~ JAN - 5 ~ _07 <br /> <br />$$688.00 (Due on ar before your anniversary date) <br />Moffat <br /> <br />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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding yeaz, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, resort, and <br />associated man. If no new disturbances or reclamation have occurred during the previous veer and no <br />new chanties to the previous year's map are necessary, then no new man is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may since for a written reporl. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Billy E. Mack <br />Permittee Name: Moffat County <br />Address: P.O. Box 667 <br />Craig, CO 81626 <br />Phone Number: (970) 824-3211 <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signature of orporate Officer, Owner, or Designee <br />Bi'Ily t:. Mack JAM 792007 <br />Date <br />on ~ Reclamation, <br />AAlning and Safety <br />M:~PERMIIIMASTERD000MENTSNS-AF-04 <br />