2004-05-07_REPORT - M2000033

• Permit No: M2000033
• IBM Index Class Name: Report
• Doc Date: 5/7/2004
• Doc Name: Annual Fee/Report/Map
• From: Moffat County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Moffat County
M-2000-033
Villard Pit #2
May 31, 2004
~.xy
RECE-VED
MAY p ~ ~
Division of Minerals a0d Geology
$688.00 (Due on or before your anniversary date)
Moffat
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an
operator shall submit the annual fee._a_report.and_mapshowing-the-extent of cun~^t-disturbances to~affeuCed- -
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach ynnr revised written annnal report and annual re~nrt maT to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Pennittee Contact:
Permittee Name:
Address:
Phone Number:
Fax Number:
Billy E. Mack
Moffat County
P.O. Box 667
Craig, CO 81626
[phone]
[phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are
enclosed.
STOCKPILE REDUCTION ONLY - NO MAP NECESSARY
Signature o Corporate Officer, Owner, or Designee
Date
M:~PERMr11MA5TERDOCUMENT$U1-AF-09