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StN - 6 ~~05~ ; ~~/ <br />ANNTiAi. FF.F, and RF.PnRT RF.nTiF,ST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Moffat County <br />6141-2002-059 <br />Sunbeam Pit #1 <br />October 1, 2005 <br /> <br />.moo ~e <br />f5 -~"' <br />RECE,~E~ <br />~j EP Z 3 p~ <br />/" J~YIijpY a! Minerals ano 4eologY <br />$688.00 (Due on or before your anniversary date) <br />Moffat <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 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 ynnr r vis d wri en anm~al r nnrt and annual report main to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />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) 824-0656 <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 farm along with your written report and map. Annual Report instructions are <br />enclosed. NO MAP NECESSARY. STOCKPILE REDUCTIOPJ ONLY. <br />Signatu e f Corporate Officer, Owner, or Designee <br />9/07/2005 <br />Date <br />M:~PERMITMASTERDOCUMEMSM-AF-04 <br />