REP40948

• Permit No: M2000028
• IBM Index Class Name: Report
• Doc Date: 5/1/2006
• Doc Name: Inadequate letter
• From: DMG
• To: Mike A Ferrero
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMTTTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Mike A Ferrero
M-2000.028
Ferrero Pit
April 26, 2006
$281.00 (Due on or before your anniversary date)
Huerfano
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an
operator shall submit the annual fee, a report and map showing the extent of cun•ent disturbances to affected
land, reclamation accomplished to date and during the preceding year, new disturbances that aze anticipated to
occur during the upcoming yeaz, 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 yeaz, if any.
Please attach vour revised written annual report and annual reuort mau to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Mike A. Ferrero
Pemilttee Name: Mike A Ferrero
Address: 34320 Hwy. 12
Trinidad, CO 81082
Phone Number: [phone]
Fax Number: [phone]
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 aze enclosed.
Signature of Corporate Officer or Owner
Date