Laserfiche WebLink
t4't-- j-- aP -r <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REOUEST <br />AMoffat County <br />/M-1993-023 <br />Cross Mountain Pit 1 <br />July 1, 2010 <br />$791.00 (Due on or before your anniversary date) <br />Moffat <br />mcwto" <br />.? JUN 2 5 2010 <br />Dh*i <br />an Gi rfz n <br />"-ffft and Sift <br />-° According-t(rC-.R S. 3-4=3-2:5=+1.6-or-E-R-S-34-32--l-16, each-year, -on-the-anniversary--date-efAhe-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 during the previous year and no <br />new chances 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 />-f-) -.i ae' -'/ 1UL." ? <br />Signature of` o orate Officer, Owner, or Designee <br />(0 <br />Date <br />M:\PERMIT1MASTERDOCUMENTS\ 4-AF-04