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u, a~ {,a'J <br />~~ - <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Rudy Fontanari <br />~~~~f'~~li11 <br />M-1986-002 FEB 1 2 ?004 <br />Whitewater Quarry Di,isron of <br />February 26, 2004 Minerals and Ceolom~ <br />$281.00 (Due on or before your anniversary date) <br />Mesa <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 operator <br />shall-subrni~the .ann~.~al_fee,_a-relwxt_aTl(1- R1ap_shnwing_the_extent_of_cunenL_disturbances_to affecSed_land, _ <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach ysnr revised written annnal re~nrt and annual ren~rf 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: Rudy Fontanari <br />Permittee Name: Rudy Fontanari <br />Address: <br />Phone Number: <br />Fax Number: <br />3316 E. 3/4 Rd.- Rt. 1 <br />Clifton, CO 81520 <br />(970)434-7948 <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 forn along with your written report and map. Annual Report instructions are enclosed. <br />Slr`i~ a of Corporate Officer, Owner, or Designee <br />,~-. <br />~Oy <br />Date <br />M:~PERMIT~MASTERD000MENTSNd-AF-01 <br />