REP12456

• Permit No: M1999048
• IBM Index Class Name: Report
• Doc Date: 7/15/2002
• Doc Name: 2002 Annual Report
• From: Moffat County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST

RECEIVED
PERMIITEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Moffat County
M-1999-048
Little Snake Pit #26
July 22, 2002
JUL 1 5 2002
Division of Minerals and Geology
$688.00 (Due on or before your anniversary date)
Moffat
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
opeiatoi shall submit the annual-fee, a ieport and map "showing the extent of Curren[ 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. Please note that an
adequately labeled map that clearly delineates and 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:
Permittee Contact: JI7(di#tY~(Rd6ibJt
Permittee Name: Moffat County
Address: P.O. Box 667
Craig, CO 81626
Bill.v E. Mack, Interim Director
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are
enclosed.
Stockpile Reduction Only - No Map Necessary
11,~Q„ .9 ~~~n
Signatt.'ct of Corporate Officer or Owner
Billy E. Mack, Interim Director
Date
M:~PERMI'IVNASTERDOCUMENTSU1-AF-04