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brn,~ <br />.• <br />RECEIVED <br />DEC 2 72005 <br />Division of Minerals and Geology <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />A. Blasi & Son Trucking &Earthmoving, Inc. <br />M-2002-109 <br />Cacharas Pit <br />January 24, 2006 <br />$281.00 (Due on or before your anniversary date) <br />Huerfano <br />m~z, <br />--_According~o.C.R_5.34;325_116.o~C.R.S-34.3211.6,_each_year,-ottthe~nniv~rsary~te~thepermit~anoperator <br />shall submit the annual fee, a report and map showing the extent of cunent 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 ynnr revised written annnal re~nrt and annnal report mad to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the 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 />PermitteeContact: AnthonySlnssi-Blws~ <br />Permittee Name: A. Blasi & Son Trucking & Earthmoving, Inc. <br />CPS OF 05~2.o05~'A• CiLa.S~ 8c Sov~ Truc4(~v~g pi. Eavl:ln.w~.av~ru~ LLC . <br />Address: 38043 CR 32.4 <br />Trinidad, CO 81082 <br />Phone Number: (719) 845-8785 <br />Fax Number: (719) 845-8786 <br />If you have additional cornments 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 />~_, ~c~~ <br />Signature of Corporate Officer, Owner, or Designee <br />iz/zz/zoos <br />Dates <br />