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• iii iiiiiiiiiiiii iii • <br />ANNUAL REPORT <br />PERMITTEE NAME: Moffat County <br />PERMIT NO.: M-89-112 <br />OPERATION NAME: Refuge Pit #1 <br />ANNNERSARY DATE: December 08, 1999 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $225.00 <br />COUNTY: Moffat <br />~ECEIVEp <br />NOV 19 1999 <br />.,:on of Minerab & Geplogy <br />According to C.R.S. 34-32.5-116(3)(a), each year, on the anniversary date of the permit, an operator <br />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 <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginning of active operations, and the date active operations ceased for the year, <br />if any. <br />Please attach vour revised annual report map and written resort to this annual report. Please <br />note drat mt adequnrely labeled map that clearly delineates and inchides the above elemerus rnm~ <br />suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: L~.,.~~~5 R• ~o~Jr~S <br />Company t=~4T ~ocl~`'l I~oAL~ l~e".pl •• <br />Adddress:~h-.O. ~o~C L[.~ <br />etZ.2~~ ~o ~l~Z~ <br />Phone No.: (970) ~Z~ - 32 l 1 <br />Fax No.: <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach i[ to this report form along with your map and/or written <br />report. S-~oCiLPt~~ ~~,DtiJCT~or.1 OrJt~ ~ No !~}Ap <br />N~e~ss ~aa y <br />/~ a~-9% <br />Signature of Co orate fficer, or Owner 'Date <br />INSTRUCTIONS ON BACK <br />