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+PF } ~Q l <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Moffat County <br />M-2002-059 <br />Sunbeam Pit #1 <br />October 1, 2007 <br />$$791.00 (Due on or before your anniversary date) <br />Moffat <br />U <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 aze anticipated to <br />occur during the upcoming yeaz, 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 your revised written annual report and annual resort mao to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated mao. If no new disturbances or reclamation have occurred durinc the previous year and no <br />new chances to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Billy E. Mack <br />Moffat County <br />P.O. Box 667 <br />Craig, CO 81626 <br />(970)824-3211 <br />(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 form along with your written report and map. Annual Report instructions aze <br />enclosed. <br />.phi,, il~~~~ <br />Signa f Corporate Officer, Owner, or Designee <br />Bi71y E. flack, Director <br />October 3 2007 <br />Date <br />RECEIVED <br />~~ 0 92007 ~~ <br />Dms~°" °fReclameU°n, <br />Mining and $aI <br />M:~PERMTIVvIASTERDOCUMENTS\M-AF-04 <br />