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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Anthony Zellitti <br />M-1980-246 <br />Zellitti Pit <br />MAR 0 1 yp05 <br />February 28, 2005 ~I vision o/Minerals and <br />Geology <br />$688.00 (Due on or before your anniversary date) <br />La Plata <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 annual fee, a report and map showing the extent of current disturbances to affected land, <br />*eclama[ionaccnmTl;cherl todate_anrLduring..the_preceding_year,_neiu-disturbances-Yhat-ares~uticipated_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 far the year, if any. <br />Please attach ymrr revised written anm~al rennrt and annnal rennrt m to this Snrm. 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: <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Anthony Zellitti <br />Anthony Zellitti <br />2001 CR 300 <br />Durango, CO 8130 <br />(970) 247-3834 <br />j970)563-4238 <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 />Signature of Cor rat flicer, Owner, or esignee <br />o~ - ~i 8' " O ~~ <br />Date ~ <br />