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~ 9~ ~ ~ • III IIIIIIIIIIIIIIII • ~~~° ~7 <br />~~,~ 999 ~-~a ~~- ~~ <br />ANNUAL REPORT - <br />i <br />PERMITTEE NAME: Moffat County gECEIVED 1 <br />PERMIT NO.: M-78-085 ~V/ <br />OPERATION NAME: Smith Pit No 20 APR 16 1999 <br />ANNIVERSARY DATE: May 25, 1999 ~1v~swn°tMaterats~Geob9Y <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Moffat <br />In order to ensure that our records are up to date, please attach your revised annual report map and written <br />report to this aimual report. Note that a written report is not necessary if the map addresses all the <br />items listed in the attached instructions concerningmining disturbance and reclamation update <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: M 0 t-i-F4~ ~[7J rJ i --I (~C'~~ ~ic.pT <br />Contact Name: l7c w~nJ ~ S 2. ~o+-t cS Company: <br />Address:: P O , 130X Lc Co `l Phone No.: (970 1 S3 Z5L - 3 Z I l <br />~l2At [,~, ~ ~ 1 io z r, Fax No.: (q 70) ~.Z~1- O3 56 <br />Comments:: J i DCtL(~ ~ i-~ 2 ~~~~J ~ i t O i..J ©/~J cam.-! <br />Signature <br />Officer, or Owner <br />~//-99 <br />Date <br />INSTRUCTIONS ON BACK <br />M:~DNRhII.~t.4A5TERDUI-AF-01. <br />