2009-12-09_PERMIT FILE - M2009079

• Permit No: M2009079
• IBM Index Class Name: PERMIT FILE
• Doc Date: 12/9/2009
• Doc Name: Response letter dated 12/07/2009
• From: Baseline Corporation
• To: DRMS
• Email Name: GRM
• Media Type: D
• Archive: No

MOFFAT COUNTY CLERK AND RECORDER
221 W. Victory Way
Craig, CO 81625
[phone]
MINING/ RECLAMATION FORM
File Number t "I t �, r� (1� l�' ��
Drawer Number
Return Date
Date-
Received From Pf - e i 510" o n+ I
Mailing Address P,o,Y. 0, 7?o
) I �; -11 (-) (-I -1 CC 31� - 3?
Mining and Reclamation Application for:
Name of Pit or mine:
Date on which inspection period is over and application may be retrieved by
Applicant:
Agent Signature:
For:
Attest: County Clerk or Deputy: 9
) ' X �'/-z