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<br />~l. <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Moffat County <br />M-1980-239 <br />Sweeney Pit No 30 <br />December 19, 2006 <br />`~' 5 2007 <br />::sit=~wr <br />$$688.00 (Due on or before your anniversary date) <br />Moffat <br />__ _ _. _According_to. C.R.S. -34-32.5-1,16_or_C_R.S. 3432-L16,_each_year,_on 1he_anniversary_date_u~the_permit,_an _ <br />operator 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 vour revised written annual report and annual report man to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred durinc the previous veer and no <br />new chances to the previous year's moo are necessary. then no new moo is required. provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />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 Billy E. Mack <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Moffat County <br />P.O. Box 667 <br />Craig, CO 81626 <br />(970)824-9249 <br />(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. Annua] Report instructions are enclosed. <br />~~~,. ~ ~vr e~Q <br />Signature ~orporate Officer or Owner <br />/-9-07 <br />Date <br />