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.' ~ <br />ANNUAL FEE and REPORT REQUEST <br />RECEfVED <br />AUG 0 9 2002 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Moffat Limestone Company <br />M-1982-141 <br />Juniper Quarry <br />August 9, 2002 <br />$688.00 (Due on or before your anniversary date) <br />Moffat <br />Division 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 operator <br />- -shall sabmit-the annual-fee; areport- and map shoivina *.he extent of--current-disturbances-to -affected-land,- -_ <br />reclamation accomplished to date and during the preceding year, new disturbances [ha[ are anticipated [o occur <br />during [he upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual resort and annual report map to this form. Please note that an <br />adequately labeled map that clearly 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: Darryl L. Steele <br />Pemtittee Name: Moffat Limestone Company <br />Address: P.O. Box 205 <br />Maybell, CO 81640 <br />Phone Number: (970) 272-3000 <br />Fax Number: (970) 272x3215 <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 instmctions are enclosed. <br />9~i2G%~.~/'~ <br />Signature Corporate Officer or Owner <br />g-G-OZ <br />Date <br />M:~PERMn VNASTERDOCUMEMSNI-AF-01 <br />