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~~s <br />PERMI'fTEE NAME: <br />PERMIT NO.: <br />OPERA"f10N NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE UUE: <br />COUN"I'Y: <br />~Urifa[ County <br />M-1999-048 <br />Little Snake Pit #26 <br />July 22, 2004 <br />~~ ~ <br />RECEI~f~~`~ <br />SEP;O 22004 <br />Oirision of Minerals and Geology <br />$688.00(Due on or before your annivcrsary date) <br />19offat <br />According to C.R.S. 34-325-11G or C.R.S. 34-32-1 ]6, each year, on the annivcrsary date of 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 t'o date and dining 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 amrual rennrt and annual rcnnrt man to thic corm. Please note That an <br />adequately labeled map that cleerly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following pennittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Billy 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 [hat should be provided ro 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 />STOCKPILE REDUCTION ONLY <br />Signature orporate Officer, Owner, or Designee <br />AUGUST 18, 2004 <br />gate <br />Af:\PERMI T\MASTI?ROOCUM[N 1 SNI-Ar-OS <br />