2006-03-13_REPORT - M1978007

• Permit No: M1978007
• IBM Index Class Name: Report
• Doc Date: 3/13/2006
• Doc Name: Annual Fee/Report/Map
• From: Moffat County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

03/13/2006 11:26 9708240356
PERMTTTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DA'I'S:
Moffat Connty
M-1980-248
Lyons Pit No 2
MOFFAT COUNTY ROAD
RECE~~dE~
MAR 13 20Q6
Febraary 4, ,2006 Division of Minerals & Gsa~vsy
ANNUAL FEE DUE: $688.00 (Doe on or before yoar anniversary date)
COUNTY: Moffat
PAGE 02
According to C.R.S. 34-32.5-116 or C.RS. 34-32-116, each year, on the anniversary date of the permit, an
opcrstor shall submit the annual fee, a report and map showing the extent of current distta'bances to affected
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during the upcomung yeaz, reclamation that will be performed dosing the coming yeaz, the dates for the
beginning of active operationsq, and the date active operations ceased for the yeaz, if arty.
Plpace aftac,~ynnr rnvicnd written annnnl re!,pnrt and annual repnrf mao~tn this form. please note that ah
adequately labeled map that clearly delineates and includes the above elements may since for a written
report.
Division records indicate the following pemtittee contact information. Please verify and make any necessary
changes:
Per»tittee Contact: Bil)y E. Mack
Permittce Name: Moffat County
Address: P.O. $ox 667
Craig, CO 81626
Pho»e 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 a»d map. Annual Report instructions arc
enclosed. STUCK _ ~H~U RE'CLAMATTON ONLY. 'NO SIGNIFICANT INCREASE IN
DISTURBANCE- N0'MAP N6CESSAAY.
Siggnnatwrdgff Corporate Officer, Owner, or Designee
Bil1y'E. ~4ack, Direcsor Moffat.Gounty Road & Sri'dge
-~~ l~-D~
Date
M.~~PERMn7V.fASTT?annf'f aAFNTCIM_eA_IN