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<br /> <br /> <br /> ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: v Moffat County <br />PERMIT NO.: / M-1980-248 <br />OPERATION NAME: Lyons Pit No 2 <br />ANNIVERSARY DATE: February 4, 2010 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Moffat <br />Receiv <br />?i AN 29 2010 <br />OWN" Of <br />Mining 4 $0Pety t!©n, <br />According-to C:R:S-34=32:5=1.16_ or-C'..R-.S.-34-32=1-1°6, each year, -on the -anniversary Sate of the <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 vour revised written annual report and annual report map 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 during the previous year and no <br />new changes to the previous vear'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 />-\'VAq -Z 4-m-L&A <br />Signatur Corporate Officer, Owner, or Designee <br />/11 07 I Q <br />Date <br />M:\PERMIT\MASTERDOCUMENTS\A4-AF-04