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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Jo Ann Vota <br />M-1982-Oll <br />Hillyer Pit <br />June 24, 2002 <br />RECEI VEp <br />JUN 0 5 2QQp <br />Division of Minerals and Geology <br />$281.00 (Due on or before your anniversary date} <br />San Juan <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_ submit_the annuaLfee,_a_report_andlnap_showiug_the_extent~f_cttct~nt_di_cnubances_to_affectect_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 vour revised written annual report and annual report mau to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Joanna Vota <br />Permittee Name: Jo Ann Vo[a <br />Address: P.O. Box 3142 <br />Phone Number: <br />Fax Number: <br />Durango, CO 81302 <br />(970)259-1319 <br />!1)CY t".62aitec~~ <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 enclosed. <br />- ~ a <br />Signat e of Corporate Officer or Owner <br />. ti ~~ C72 <br />Date <br />M?PERMFMAASTERDOCUMENTSVN-AF-01 <br />