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I~~' ]L~~tlt.® <br />~'~ ._ v <br />/MAR 1 ~ 2006 ~~ <br />;,w~sion of Minerals and Geology <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Cr.~l1~ <br />v Moffat County 1( ' <br />~M-1992-007 ~ ~ <br />,~, r <br />Tuttle Pit No 1 <br />March 5, 2006 <br />FEB - 3 «)06 <br />$688.00 (Due on or before your anniversary date) <br />Moffat <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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for [he <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written annnal rennrt and annnal re nn rt man to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />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 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 aze <br />enclosed. Stockpile Reduction Oniy - No Map Necessary. <br />app, ~ ~1~ <br />Si~na~~re Co orate Officer, oowner, or Desi ee <br />Billy 11ack, [~irector Ploffat County ~oad & Bridge <br />~.- ~~ ~od <br />Date <br />M:~PERMI'I~MASTERDOCUMEN7'SN1-AF-04 <br />