2007-07-16_REPORT - M2003073

• Permit No: M2003073
• IBM Index Class Name: Report
• Doc Date: 7/16/2007
• Doc Name: Annual Fee/Report/Map
• From: Moffat Limestone Co., Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNfVERSARY DATE
ANNUAL FEE DUE:
COUN"CY:
~- ~ ~~ P -~
AN AL FE and REPORT REQUEST
Moffat Limestone Co., Inc.
~M-2003-073
Juniper Mountain Gravel
July 21, 2007 ~~ ~
$$685.00 {Due on or before your anniversary date)
Moffat
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~tJL 1 G 2007
~sion otak a Safety n
Mining
According to C.R.S. 34-32.5-I 16 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 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 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 durinc the previous year and no new chances to
the previous year's mao are necessary, then no new mao is required, provided that the Operator shall state
this in the Annual Report. Please note that an adequately labeled map that clearly delineates rind 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:
Peimittee Confact: Danyl L. Steele
Permittee Name:
Address:
Phone Number:
Fax Number:
Moffat Limestone Co., Inc.
62207 U.S.40
P.O. Box 205
Maybell, CO 81640
[phone]
[phone]
If you have additional comments and/or information that should be provided to the Division, please provide
below or attach it to this form al~ong~with your written report and map. Annual Report instructions are enclosed.
Signature Corporate Officer, Owner, or Designee
Date
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