2002-12-12_REPORT - M1980239

• Permit No: M1980239
• IBM Index Class Name: Report
• Doc Date: 12/12/2002
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
RECEIVED
DEC t 2 2002
PERMITTEE NAME:
PERMfT NO.:
OPERATION NAME:
ANNP/ERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Moffat County
M-1980-239
Sweeney Pit No 30
December 19, 2002
Division of Minerals and GeoloAY
$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
operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected
an , rec ama ton accompus a to ate an unng t e prece mg year, new tstur ances t at are annctpated 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.
(See Map Attached)
Division records indicate the following permittee contact information. Please verify and make any necessary
changes;
PermitteeContact: $l~i~sXTXr~ Billy E. Mack
Permittee Name: Moffat County
Address: P.O. Box 667
Craig, CO 81626
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
enclosedOn all of Moffat County's Annual Fee Reports:
Please remove Dennis Jones from
Replace it with Billy E. black.
Signature Corporate Officer, Owner, or Designee
Billy E. Mack
Date
the Permittee Contact list and
M:~PERMITMASTERD000MENTSN9-AF-04