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7 <br /> <br /> <br />ANNUAL FEE and REPORT REQUEST <br />C~:'dED <br />2~~~ <br />PERMITTEE NAME: Dave Direzza <br />Divis <br />PERMIT NO.: M-1984-028 <br />OPERATION NAME: Direzza Pit ~/ <br />ANN[V ERSARY DATE: May 1, 2001 ~~I ~/ <br />ANNUAL FEE DUE: ue on or before your andfvefsaf~y date) <br />COUNTY: Bent <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary <br />operator shall submit the annual fee, a report and map showing the extent of current di <br />land, reclamation accomplished [o date and during the preceding year, new disturbances <br />occur during the upcoming year, reclamation that will be performed during the coming <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />of M;,~~ als and Geology <br />of the permit, an <br />lances to affected <br />are anticipated to <br />[he dates for the <br />Please attach your revised written annual report and annual report maa to this form. Please no[e tha[ nn <br />adegunrely labeled map tha[ clearly deloteates ar:d includes the above elements may Jfice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and ~rtake any necessary <br />changes: <br />Permittee Contact: Dolores DiRezza <br />Permittee Name: Dave Direua <br />Address: ~' <br />0 <br />Phone Number: ~-~7-19}38#=3802 <br />Fax Number. ~7tn~ae G9^ <br />If you have additional comments and/or information that should be provided to the D <br />below or attach it to this form along with your written report and map. Annual <br />enclosed. <br />~ ~~~hqs <br />Signature o Corporate O tc caner L ~/ /"/ / (/tC/ ~( <br />`~ 3' O/ <br />Date <br />~bOG~ ~O "~/i <br />please provide it <br />instructions are <br />~~~ <br />~~ y <br />M: SPERM ITV.1ASTERDOCUIv1ENTS~M-AF-01 <br />