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CK -fl3o 576 41019 $ <br /> ANNUAL REPORT RECEIVED <br /> AUG 17 2000 <br /> PERMITTEE NAME: Moffat County <br /> PERMIT NO.: M-1998-047 Division of Minerals and Geology <br /> OPERATION NAME: Mantle Pit#3 <br /> ANNIVERSARY DATE: September 9, 2000 <br /> ANNUAL FEE DUE ON ANNIVERSARY DATE: $688.00 <br /> COUNTY: Moffat <br /> According to C.R.S. 34-32-116(3)(a), 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 <br /> to affected land, reclamation accomplished to date and during the preceding year, new <br /> disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br /> performed during the coming year, the dates for the beginning of active operations, and the date <br /> active operations ceased for the year, if any. <br /> Please attach your revised annual report map and written report to this annual report. <br /> Please note that an adequately labeled map that clearly delineates and includes the above <br /> elements may suffice for a written report. <br /> Please type or print the current contact person's name, mailing address, and phone number in the <br /> space provided: <br /> Dennis R. Jones Moffat County Road Dept. <br /> Contact Name: Company: <br /> Address: P. O. Box 667 Phone No.: (970 ) 82 -3211 <br /> l.Ct t.6 g( 6 a(0 FAX No.:� ) <br /> e-mail: <br /> If there are additional comments and/or information that should be provided to the Division, <br /> please provide it on a separate sheet and attach it to this report form along with your map and/or <br /> written report. No new disturbance - Stockpile reduction only <br /> (No Map Necessary) / <br /> — 7 - <br /> S nan �Pture o r- Officer, or Owner Date <br /> nis one <br /> (Road Sup visor) <br /> INSTRUCTIONS ON BACK <br /> M dPERMnWASTERDUCUMENTSW AF 04 <br />