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<br />ANNUAL FEE and REPORT REQUEST <br />RECEIVED <br />PERMITTEE NAME: Moffat County SEP 0 6 2001 <br />PERMIT NO.: M-1998-049 <br />Division of Minerals and Geology <br />OPERATION NAME: Mantle Pit #3 <br />ANNNERSARY DATE: September 9, 2002 <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 />nperatnr~hall_sabtnit_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 [hat 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 your revised written annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly defineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permi[tee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: ~~(,fWttt~ <br />Permittee Name: <br />Address: <br />Moffat County <br />P.O. Box 667 <br />Craig, CO 81626 <br />Billy E. Mack.(Director) <br />-(970j823~21-1--- - - <br />Fax Number: (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 Only - No Map Necessary <br />/.l.~Q~ ~ ~l .. <br />Signatu of Corporate Officer, Owner, or Designee <br />Billy E. Mack, Director <br />~- D-ch'~ <br />Date <br />M:~PflRMRU1ASTERD000MENTSN-I-AF-04 <br />