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<br /> <br />RECEIVED <br />APR 2 6 2004 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Dave Direzza <br />M-1984-028 <br />Direzza Pit <br />May 1, 2004 <br />$281.00 (Due on or before your anniversary date) <br />Bent <br />~hi~unmA~Otiiner~lc L ~// <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 current disturbances to affected land, <br />--- ~-recfiamati~ma~i~n~plished'tb`lcrte anei-durin~fie preceding"year, new distu-Gr antes that are anhcipated`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 ynnr revised written annual rennrf and anm~al re~nrf m ~n fn 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 />Permittee Contact: Dolores DiRezza <br />Permittee Name: Dave Direzza / <br />Address: 4815 Hwy 194 <br />La Animas, CO 8 1 054-941 1 t~ <br />Phone Number: (719) 456-2266 `/ / <br />Fax Number: (719) 456-2266 ~/ <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 />~gnatu/re of Corporate fficer, Owner or <br />~'7- -~ / ~-O~ <br />Da <br />