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A"Ay"V'C?a <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REOUEST <br />Anthony Zellitti / <br />M-1980-246 ? <br />Zellitti Pit <br />February 28, 2009 <br />RF('% jVej) <br />MAK ' b 0009 <br />Division or Keclama <br />Mires and S tion <br />a,, <br />$791.00 (Due on or before your anniversary date) <br />La Plata <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 <br />operator shall submit- the- annual fee,-a report and-map showing the-extent-of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning 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 <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may suffice for 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: <br />Address: <br />Anthony Zellitti <br />2001 CR 300 <br />Durango, CO 81301 <br />Phone Number: (970) 247-3834 <br />Fax Number: (970) 563-4238 <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 />;?? 4'A' <br />Signature of orate Officer or Owner <br />ate