2005-01-14_REPORT - M1997027

• Permit No: M1997027
• IBM Index Class Name: Report
• Doc Date: 1/14/2005
• Doc Name: Annual Fee/Report/Map
• From: A. J. Botti Construction & Gravel
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
A. J. Botti Construction & Gravel
M-1997-027
Moonscape Pit
January 30, 2005
$281.00 (Due on or before your anniversary date)
Delta
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
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 ynnr revised written anm~al rPpnrt and annual report main to this form. please note that ari
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: Andrew J. Botti
Permittee Name: A. J. Botti Construction & Gravel
Address: 4608 Sundown Rd.
Delta, CO 81416-9107
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.
Signatu~/o Corporate Officer( woe or Designee
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Date