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r~~ .; <br />PERMITTEE NAME: Moffat County ~ .,,j <br />PERMIT NO.: M-1980-248 <br />OPERATION NAME: Lyons Pit No 2 <br />ANNIVERSARY DATE: February 4, 2005 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: 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-aeeamp}ished-to-date-and-during the-praeedirg-year,-new-disturbances-that-are-anticipated ~o .-- - <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 revised written annual rennrt and annnal report man 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: <br />P.O. Box 667 <br />Craig, CO 81626 <br />Phone Number: <br />Fax Number: <br />(970) 824-3211 <br />(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 />STOCKPILE REDUCTION AND RECLAMATION ONLY. NO SIGNIFICANT INCREASE.IfJ DISTURBANCE. <br />N MAP N^C~AR~~ <br />Signature orporate Officer, Owner, or Designee <br />Dale <br />- ,„ - <br />M:IPERMIIIMASTERDOCUMENTSNr-AF-04 <br />