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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Moores Mining Ranching & Mill <br />M-1980-178 <br />Moores Pit <br />September 15, 2003 <br />$281.00 (Due on or before your anniversary date) <br />Mesa <br />RECEivE~ <br />SEP 15 20D3 <br />Dnrislpn ~f Minerals and Geplpgy <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />please atta~ynnr revised written annual rennrt and anneal rennrt m~tn this form. Please note drat an <br />adequately labeled map that clearly 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: Jean Moores <br />Permittee Name: Moores Mining Ranching & Mill <br />Address: 32906 Hwy 141 <br />Gateway, CO 81522 <br />Phone Number: (970) 931-2802 <br />Fax Number: (970) 931-2802 <br />Tf 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 enclosed. <br />Signa a of Corporate Officer, Owner, or Designee <br />