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1/ <br />~1.1 ~~. <br />,~~ -, 'FD <br />~_ > <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNPJERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Rudolph Fontanari <br />M-1996-076 <br />Western Slope Flagstone Quarry No. 2 <br />Aprill6, 2003 <br />$281.00 (Due on or before your anniversary date) <br />Mesa <br />MinE,,; :; ai,d <br />Leo/d9y <br />RECE~V~D <br />oidist JUC ~ ~ ?Op3 <br />uo ~f Minorats and dept o9Y <br />_ According to C.R_.S. 34-3.2.5-116 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 year, 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 ym~r revised written annual report and annual report m ~n to this frtrm- Please note JhaJ an <br />adequately labeled map that clearly 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: Rudolph Fontanari <br />Permittee Name: Rudolph Fontanari <br />Address: 3316 E. 3/4 Rd. - Rt. 1 <br />Clifton, CO 81520 <br />Phone Number: <br />^Fax Number: <br />(970)434-7948 <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 />-~~~~~~il~ri <br />Signature f Corporate Officer, Owner, or Designee <br />~-3v-o3 <br />Date <br />ti <br />M:\PERMITUTASTERDOCUM ENTS\M-AF-01 <br />