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<br />~...• d~Z0~1 ~ <br />birS;!or .,,.. ~ :rlamatitwt, / <br />P:~inL,g snd Satafy ~ E <br />ANNUAL FEE an~REP <br />PERMITTEE NAME: / Moffat County <br />PERMff NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~M-2000-033 <br />Villard Pit #2 <br />May 31, 2007 <br />APR - 9 2007 <br />- ,I~ <br />$$688.00 (Due on or before your anniversary date) <br />Moffat <br />a~ <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'stiowmg tfie extent of current disturbances to' affected----- - <br />land, reclamation accomplished to date and during the preceding year, 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 Your 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, report, and <br />associated map. If no new disturbances or reclamation have occurred durine the previous year and no <br />new changes to the previous year's map are necessary, then no new map 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 report. <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: (970) 824-0356 <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 orporate Officerer, or Designee <br />Billy E. Mack, Director <br />Date <br />M:~PERMI'M4ASTERDOCUMEMSVvt-AF-o4 <br />