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<br />RECEIVED <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, 2003 <br />JUL 3 U 2003 <br />Oirision of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Moffat <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 />sti~tl-su(imit-the annual-fee,-a report and-tnap~howCng-th'e exferit-of current disturbances to-affected-land- <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the 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 ynur revised written annual rennrt and annual rennrt map to thin fnrm_ Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice 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 />Permittee Name: Moffat Limestone Company <br />Address: P.O. Box 205 <br />Maybell, CO 81640 <br />Phone_L~Itamb~r:_(Q7.4)-272.3.404.._._ <br />Fax Number: (970) 272-3215 <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 instructions are enclosed. <br />~1'tS ~c%yT <br />Signature orporate Officer, Owner, or Designee <br />7^3d-o3 <br />Date <br />M:~PERMI7IMASTERDOCllMENTS~M-AF-OI <br />