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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Moffat County <br />M-1978-007 <br />Big Buru Pit No 17 <br />February 23,2003 <br />RECEIVED <br />FEB 14 pp03 <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Moffat <br />Accordin tg o 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 />operator shall submit the annual fee, a report and map showing the extent of cur~ent-Ir ishu ances o a ecfed-` =- <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 ymrr revised written annnal report and annnal rP~nrt main to this Torm_ 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: )~A~P#~;K~XXq~k <br />Permittee Name: <br />Address: <br />Moffat County <br />P.O. Box 667 <br />Craig, CO 81626 <br />Phone Number: (970) 824-3211 <br />Fax Number: <br />Billy E. Mack <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 Repor[ instructions are <br />enclosed. <br />STOCKPILE REDUCTION ONLY - NO MAP NECESSARY <br />Signature Corporate Officer, Owner, or Designee <br />Billy E. Mack, Interim Director <br />~ - ~:~ -off <br />Date <br />M:~PERMITVNASTERp000MENTSVN-AF-04 <br />