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ANNUAL FEE and REPORT REQUEST <br />' ~J <br />RECEIVED <br />MAR 012004 <br />PERMIITEE NAME: <br />PERMTI' NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Anthony Zellitti <br />M-1980-246 <br />Zellitti Pit <br />February 28, 200+4 <br />$68&00 (Due on or before your anniversary date) <br />La Plata <br />Division of Minerals & Geology <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 yeaz, 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 reuort maa to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice far a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Anthony Zellitti <br />Permittee Name:. Anthohy ZeHitti <br />Address: 2001 CR 300 <br />Durango, CO 8[301 <br />Phone Number: (970) 247-3834 <br />Fax Number: Cq.~) ~i_ x' ~7 7 Y~ _ <br />If you have additional comments and/or infotmation 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 aze enclosed. <br />MiPERMI'nMASTERDOCUMENTNN-AF-01 <br />