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Pennittee 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 />Si ' Corporate Officer, Owner, or Designee <br />Date <br />M: \ PERMIT\MAS TERD \M -AF -04 <br />RECE!V <br />p / JUN C47U11 <br />�-1 4iviswn of RQclamati® <br />Madag <br />r�, <br />ANNUAL FEE and REPORT REQUEST <br />RECEIVED <br />PERMITTEE NAME: 1 Moffat County <br />JuN 2 <br />r" 4 <br />PERMIT NO.: /M- 1993 -023 <br />Division of R@ @loRi1ol ®fl <br />OPERATION NAME: Cross Mountain Pit 1 Mining $ Softly <br />ANNIVERSARY DATE: July 1, 2011 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Moffat <br />According to C.R S._34- 32.5 -1-1.6 or_C.R.S 4- 32 --1-14 each - :oars: the - anniversary- date-ef -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 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 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 />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 />