2005-06-23_REPORT - M1982011

• Permit No: M1982011
• IBM Index Class Name: Report
• Doc Date: 6/23/2005
• Doc Name: Annual Fee/Report Notice
• From: jo ann vota
• To: dmg
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Jo Ann Vota
M-1982-011
Hillyer Pit
Juue 24, 2005
$281.00 (Due on or before your anniversary date)
San Juan
JUN 2 ~ 2uU5
Division of Minerals & 6~olOgy
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
shall submit, the annual fee,-a-report and map showing the-extent of currenC'disturbances to .affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual rennrt and annnal report main to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Joanna Vota
Permittee Name: Jo Ann Vota
Address: 315 N. Sunburst Ln.
Durango, CO 81301
Phone Number: [phone]
Fax Number:
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
G
Signa a of Corporate Officer, Owner, or Designee
d -<I -oS
Date