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<br />RECEIVED <br />APR 0 4 2003 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Moftat County <br />M-1998-003 <br />Raftopoulos Pit #1 <br />Apri128, 2003 <br />$688.00 (Due on or before your anniversary date) <br />Moffat <br />~7ivisien of Minerals and Geology <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 />_,_o~erator 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 are anticipated to <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 mnr revised written annual re~nrt and annual repor to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice 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: P.O. Box 667 <br /> Craig, CO 81626 <br />~hone'irliirnber -'(970}'824=321'1 <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 />STOCKPTLE REDUCTION ONLY - NO MAP NECESSARY <br />j! ie ~' ~"Vi w R <br />Signatu ~ f Corporate Officer, Owner, or Designee <br />Billy E. Mack., Director <br />March 12, 2003 <br />Date <br />M:~PERMITMASTERDOCUMENTSU~I-AF-04 <br />