Laserfiche WebLink
ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Moffat County NOV 2 7 2003 <br />PERMIT NO.: M-1989-112 <br />OPERATION NAME: Refuge Pit #1 w <br />ANNIVERSARY DATE: December 8, 2008 <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: Moffat <br />----According-to. _C.R_S._34_32..5-116 or-C.R_S.. -3_4`3_2-11.6, 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, 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 -your revised written annual report and annual report may 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 previous Year and no <br />new changes to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <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) 824-3211 <br />Fax Number: (970) 824-0356 <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 <br />enclosed <br />i?.1?-JC Q <br />Signature of0 ' orate Officer, Owner, or Designee <br />1? -t L/ <br />Date <br />M: PERMITIMASTERDOCUMENTS\M-AF-04