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r <br /> A ~ ~~' E and REPORT REQUEST <br />PERMITTEE NAME: ~ Mike A Ferrero <br />PERMTT NO.: M-2000.028 <br />OPERATION NAME: Ferrero Pit <br />ANNIVERSARY DATE: Apri126, 2007 <br />ANNUAL FEE DUE: $$281.00 (Due on or before your anniversary date) <br />COUNTY: Huerfano <br />`~``' 2?1001 <br />lion o: ~?Uamstion, <br />Mining and Safety <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~rrceding_year,ltew_dish~rl2gllc~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. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous vear and no new chances to <br />the previous year's map are necessary, then no new map is required. provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Mike A. Ferrero <br />Permittee Name: Mike A Ferrero <br />Address: 34320 Hwy. 12 <br />Trinidad, CO 81082 <br />Phone Number: (7l9) 846-Z 176 <br />Fax Number: (719) 846-7512 <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 Corpora et Officer, Owner, or Designee <br />s= /~-~~ <br />Date <br />