2008-09-02_REPORT - M1998047

• Permit No: M1998047
• IBM Index Class Name: REPORT
• Doc Date: 9/2/2008
• Doc Name: Annual Fee/Report/Map
• From: Moffat County
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

-AF A- (ze T-
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REOUEST
Moffat County /
M-1998-047
Mantle Pit #3
September 9, 2008
$791.00 (Due on or before your anniversary date)
Moffat
E-CMEA F! D
SEP 0 2 2000 t/
Division of I"eclamation,
Mining and Safety
According to C.R.S. 34-32 5 116 or C.R_.S.-3 -32=116,_each_year, on_the. anniversary date_ofthe.permit,_an_operator
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, reclamation
accomplished to date and during the preceding year, new disturbances that are anticipated to occur during the
upcoming year, reclamation that will be performed during the coming year, the dates for the beginning of active
operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report may to this form. The Annual Report &
Fee requirement is not met until we have received the following components: fee, report, and associated may.
If no new disturbances or reclamation have occurred during the previous year and no new changes to the
nrevious vear's map are necessarv, then no new map is reauired. provided that the Operator shall state this in
the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the above
elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Billy Mack
Permittee Name: Moffat County
Address: P.O. Box 667
Phone Number
Fax Number:
Craig, CO 81626
[phone]
[phone]
If you have additional comments and/or information that should be provided to the Division, please provide it below
or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
lik
Signature o C rporate Officer, Owner, or Designee
Date
M:\PERM T\MASTERDOCUMENTS\M-AF-04