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DEC 0 5 2011 <br />PERMITTEE NAME: Moffat County <br />PERMIT NO.: M- 1980 -239 �vt���, 4� gn u bafery <br />OPERATION NAME: Sweeney Pit No 30 <br />ANNIVERSARY DATE: December 19, 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- 16- or- C,R.S.- 34- 32- 116,- each- year; on -the -anniversary-dale oftlie perniit; <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 />Permittee Contact: Billy E. Mack <br />Permittee Name: Moffat County <br />Address: P.O. Box 667 <br />Phone Number: <br />Fax Number: <br />Craig, CO 81626 <br />(970) 824 -3211 <br />(970) 824-0356 <br />If you have additional comments and/or information that show <br />below or attach it to this form along with your written rer <br />enclosed. <br />Signature of Cdgorate Officer, Owner, or Designee <br />Date <br />M:IPERMITIMASTERDOCUMENTS\M -AF -04 <br />ANNUAL FEE and REPORT REQUEST <br />Check was mailed separately. <br />Check from Moffat County dated <br />November 11, 2.011 in the amount <br />of $791.00 ( #322133), <br />Please call Barbara Barrientez <br />at (970) 224 -3211 ext. 11 if <br />you have any questions. <br />et Mc <br />X7 `" % ,1 ozip <br />