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. ~ III IIIIIIIIIIIIIIII ~ <br />ANNUAL FEE and REPORT REQUEST <br />RECEIVED <br />PERMITTEE NAME: Butala Construction Company <br />PERMIT NO.: M-1987-127 APR 1 6 2001 <br />OPERATION NAME: Butala Pit division of Mine~~'- and Geology <br />ANNIVERSARY DATE: May 11, 2001 <br />ANNUAL FEE DUE: $225.00 (Due on or before your anniversary date) <br />COUNTY: Chaffee <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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding ycar, new disturbances thzt are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual reuort mau to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may sauce for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Frank Butala <br />Permittee Name: Butala Construction Company <br />Address: 7625 Hwy. 50 <br />Phone Number: <br />Salida, CO 81201 <br />(719)539-2521 <br />Fax Number: <br />(7]9)539-2523 <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 <br />enclosed. <br />Signature of Corporate Officer or Owner <br />April 13, 7001 <br />Date <br />M ~PERMITMASTERDOCUMENTSUA-AF-0I <br />