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.9~`J <br />F~ ~ Q~ T <br />PERMITTEE NAME: <br />PERMTl' NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT RE UEST <br />A.J. Botti Construction & Gravel <br />M-1997-027 i/ <br />Moonscape Pit <br />January 30, 2008 <br />$$323.00 (Due on or before your anniversary date) <br />Delta <br />RECEIVED <br />JAN D 7 2008 <br />Division of Reclamation, <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-daring the-preceding year; new-disturbancesxhat 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 />man. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's maa are necessary, then no new maa is required, arovided that the Oaerator 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: Andrew J. Botti <br />Permittee Name: A.J. Botti Construction & Gravel <br />Address: 4608 Sundown Rd <br />Delta, CO 81416-9107 <br />Phone Number: <br />Fax Number: <br />(970)874-8141 <br />(970)874-8141 <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 />ature of to Officer, Owner, or Designee <br />p~ <br />Date <br />