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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUN'T'Y: <br />~ANNIJAL FEE and REPORT REQUEST <br />ke A Ferrero <br />dM-2000-028 <br />Ferrero Pit <br />Apri126, 2006 <br />R~.Ci~~~~~~ <br />~~JUN 2 0 2006 <br />V Division of Minerais end &c~lapY <br />$281.00 (Due on or before your anniversary date) <br />Huerfauo <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 accomplished to date and during 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 vour revised written annual report and annual report 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 report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Mike A. Ferrero <br />Permittee Name: Mike A Ferrero <br />Address: 34320 Hwy, 12 <br />Trinidad, CO 81082 <br />Phone Number: (719) 846-2176 <br />Fax Number: (7-19}846-~S~I2 - - ~ ' - _....~.~„ ~ y~~"` ~-+-'~=(~- . - - <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 fonn along with your written report and map. Annual Report instructions aze enclosed. <br />ignature of Corporate Officer or Owner <br />~~ ~~~~{~ <br />Da~ ~ <br /> <br />