2005-08-29_REPORT - M1999048

• Permit No: M1999048
• IBM Index Class Name: Report
• Doc Date: 8/29/2005
• Doc Name: Annual Fee/Report/Map
• From: Moffat County
• To: DMG
• Media Type: D
• Archive: No

~6-AUG-2005 11,20 FRO1FColorado Division of Ninsrals 8 Geology [phone] T-351 P.004/006 F-743
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PERMI'I'1'EE NAME: M/offat County ~ V t
P£RMTf NO.: ~jl`I--1999-048 /qUG 2 9 2005
OPERATION NAME: Little Snake Pft ~k26
"livisinn of Minerals and 6~ ~~~'
ANNi'VfiRSARY DATE: July 22, 2005
ANN{TAL FEE DUE: $688.00 ('Dae oa or before your annfverssry date)
COUNTY: Moffat
According ro CR.S. 34-32.5-116 or C•RS. 34-32-116, each year, on the atmiverSary date of the permit, an
operator shall submit the annual fee, a report and map showing the extent of current disturbances ro affected
land, reclamation accomplished ro date and during the preceding year, new disturbances that are anticipated 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.
Plegxe attach ynttr revixed written a_nnnal re~nrf god gnnnal repn~~ to thie form. please ante that an
adequately labeled map that clearly detineates and includes the above elements may suffice for a written
report.
Division records indicate the following peanittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Billy E. Mack
Peemittec Name:
Address:
Phone Number:
Fax Number:
Moffat County
P.O. Box 667
Craig, CO 81626
(970) 8243211
{970) 824-0356
L` you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it ro this form along with your written report and map. Amtual Report instttrctions are
enclosed. Stock pile reduction only - no map required.
~l. l~~ .QiI f/L,.
Signattu~'Corpotate Officer, Owner, or Designee
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Date
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