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~~ ANNi1Ai. FF,F, and RF.PnRT RF.OiiF.ST ~~~"~ <br />PERMITTEENAME: Moffat County R~L.~I~~® <br />PERMIT NO.: M-1998-047 SEP.~ 2 ~ <br />OPERATION NAME: Mantle Pit #3 <br />ANNNERSARY DATE: September 9, 2004 Uiuision of Minerals and GeoloAY <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: 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 />"-"-land, reclamation a"-iccompl'ished'to die att~ during the prece3ing year, new distu~r antes tha~nticipate~'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 xnnr revised written anmral red ort and annnal report m ~n to this fnrm_ 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 Mack <br />Permittee Name: Moffat County <br />Address: P.O. Box 667 <br /> Craig, CO 81626 <br />Phone Number: (970) 823-3211 <br />Fax Number: (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 are <br />enclosed. <br />STOCKPILE REDUCTION ONLY <br />S~ re dt:Corporate~ r,~ er, or Designee <br />August 18. 2004 <br />Date <br />M:NERM771AtASTERDOCUMENTSVv1-AF-04 <br />