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999 V <br /> ANNUAL FEE and REPORT REQUEST RECEIVED <br /> PERMITTEE NAME: Butala Construction Company <br /> SEP 2 4 2001 <br /> PERMIT NO.: M-1977-170 0iuision of Minerals and GeclagY <br /> OPERATION NAME: Butala Gravel Pit <br /> ANNIVERSARY DATE: October 1,2001 <br /> ANNUAL FEE DUE: $688.00(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 operator <br /> shall submit the annual fee, a report and map showing the extent of current disturbances to affected 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 your revised written annual report and annual report map 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 /> Permittee Contact: Frank Butala <br /> Petmittee Name: Butala Construction Company <br /> Address: P.O. Box 907 <br /> Salida,CO 81201 <br /> Phone Number: (719) 539-2521 <br /> Fax Number: (719) 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 enclosed. <br /> Signature of Corporate Officer or Owner <br /> September 19 , 2001 <br /> Date <br /> M'TERMn MASTERDOCUMEM'SW AF-01 <br />