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h ~~ <br />fEE NAME: <br />NO.: <br />ION NAME: <br />RSARY DATE: <br />L FEE DUE: <br />ANNiiAi. FF.F. and RF,Pt7RT RF.(~iiF.ST <br />/Mike A Ferrero <br />M-2000-028 <br />Ferrero Pit <br />April 26, 2006 <br />$281.00 (Due on or before your anniversary date) <br />Huerfano <br />RECE~1/E® <br />APR 2 42006 . <br />/Dfvision of Minerals and GeobBY <br />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 />reclamation accomplished to date and during the preceding yeaz, 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 />ch ynnr reviced written anneal rennrt and anneal rennrt maw to this form. Please note that an <br />labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />records indicate the following permittee contact information. Please verify and make any necessary <br />Contact: Mike A. Ferrero <br />Name: Mike A Ferrero <br />34320 Hwy. 12 <br />Trinidad, CO 81082 <br />Phone Number: (719) 846,2176. .. J <br />Fax Null ber: ~~' ~ ~ Q - g4~p - o~ ~1 lp i/ <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 Officer, Owner, or Designee <br />Date <br />