2004-04-14_REPORT - M1996076

• Permit No: M1996076
• IBM Index Class Name: Report
• Doc Date: 4/14/2004
• Doc Name: Annual Fee/Report/Map
• From: Rudolph Fontanari
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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RECEIVEp
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Rudolph Fontanari
M-1996-076
Western Slope Flagstone Quarry No. 2
April 16, 2004
$688.00 (Due on or before your anniversary date)
Mesa
APR 14 2004
Dmsim o! Lhinerais ~'~~'
_According to C.R.S. 34-32.5_l~l_6 or C.R_S .34-32-1,16, each year,_on the.anniversary_date_of_the_permit, an operator__ _
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach ym~r revised written annual rennrt and anneal re~nrt m ~n to thin form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact:
Permittee Name:
Address:
Rudolph Fontanari
Rudolph Fontanari
3316 E. 3/4 Rd. - Rt. 1
Clifton, CO 81520
Phone Number: --[phone]
Fax Number:
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
Sign~ature~ate Officer, Owner~or Designee
11-//~-Oy
Date