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i? <br />T , <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />+ , p *- (2,f T- <br />ANNUAL FEE and REPORT REOUEST <br />Moores Mining, LLC <br />M-1980-178 <br />Moores Pit <br />September 15, 2009 <br />CE® <br />-----SEP 14 200,9 <br />?Di?*ian of Fiecl <br />Miming and on, <br />Safety <br />$323.00 (Due on or before your anniversary date) <br />Mesa <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 />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />- - --reclamation-accomplished-to date-and during-tire-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 your revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous vear's map are necessarv. then no new map is required. provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Leon Moores <br />Permittee Name: Moores Mining, LLC <br />Address: - 4294-; Highway 141 v? L9 ?v l <br />Gateway, CO 81522 <br />?r <br />Phone Number: (9703-"t--M- q te) r q31 -a go <br />Fax Number: (970) 1*6-2? R S O'b, <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 />., .moo..-tis <br />Sign re of Corporate Officer, Owner, or Designee <br />,&,f, 0 07 <br />bat q/