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~ti e, <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~'ANNi1Ai. FF.F, and RF.PnRT RF.( T] TEST <br />t/ Anthony Zellitti <br />// M-1980-246 <br />Zellitti Pit <br />February 28,2006 <br />REC~~'"'~ <br />~~ ~B ~ (; 2~~6 <br />Oi~naion of Minerals aM Geobpy <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 an map showing the extent o`f current disturbances to of of cted-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 rm~r revised written anneal report and anneal reQ~ort m ~n 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 />Pennittee Contact: Anthony Zellitti <br />Permittee Name: Anthony Zellitti <br />Address: 2001 CR 300 <br />Durango, CO 81301 <br />__~ Phone.Number:___(9701247-3834 _ <br />Fax Number: (970) 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~orat€ Officer, Owner, or Designee <br />~2.~I~~4? (o <br />Date <br />