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;:. :~~ <br />~~ ~ ~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Moffat County <br />M-1980-239 <br />Sweeney Pit No 30 <br />December 19, 2007 <br />a.:w...-.. ~. <br />`/ <br />d~C <br />0 ~ 2007 <br />Division of Fteclamatio~ <br />Mining and Safety <br />$$791.00 (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 <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, ne gdisturbances tear, the datesfo the <br />occur during the upcoming year; reclamation that will be performed durin the coming y <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach our revised written annual re ort and annual re ort ma 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 durin the revious ear and no <br />new chap es to the revious ear's ma Rae o ~ ces pleasehnote that anadequately labe ed map thath learhly <br />Operator shall state this in the Annual ~_ <br />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: Billy E. Mack <br />Permittee Name: Moffat County <br />Address: P.O. Box 667 <br />Craig, CO 81626 <br />Phone Number: (970) 824-9249 <br />Fax Number: (970) 824-0356 <br />(970) 824-3211 <br />If you have additional comments and/or informationwtrhitten ~e lort and map. toAnnuall Reportpinstructionsdare <br />below or attach it to this form along with your P <br />enclosed. <br />~~ ~~- <br />.. <br />g~~yhEe~ ack~;oDi reOctor' Owner, or Designee <br />t'(-3C/-ah <br />Date <br />M:~PERMITVvIASTERDOCLTMENTS~IvI-AF-04 <br />