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c~ti ~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />(~ ANNiiAi. FF.F, and RF.PnRT RF.(liiF.ST <br />Jo Ann Vota <br />/M-1982-011 <br />Hillyer Pit <br />June 24, 2006 <br />$281.00 (Due on or before your anniversary date) <br />San Juan <br />RECEa'~1EC <br />`JUN d 7 20U6 <br />t/pi~ision at Minerals and ~eoloBY <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 cuttent disturbances to affected land, <br />- reclamation accomplished-to date and during the preceding year, hew disturbances that are anticrpated 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 ymrr revised written anmral re~rt and annnal re nn rt marn to this form. Please note that an <br />adequately labeled map [hat 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 Vota <br />Address: 315 N. Sunburst Ln. <br />Durango, CO 81301 <br />Phone Number: (970) 259-1319 <br />Fax Number: <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 />of Corporate <br />or Designee <br />~ b _ / - <br />Date <br />