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RECD@~.~E® <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Tony J• Beltramo & Sons, Inc. <br />M-1998-101 <br />Cesar Pit <br />March 29, 2002 <br />MAR 2 1 2002 <br />DiYision of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Pueblo <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />- - -reclamation~aecomplished to-date-and-daring--the preceding-ycae,-new-distu:bances tlrt-are-anticipated-to-occur- <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: 3estplt$elhamm <br />Permittee Name: Tony J. Beltramo & Sons, Inc. <br />Address: 1541 Stockyard Rd. <br />Pueblo, CO 81001 <br />Phone Number: <br />Fax Number: <br />(719)544-4744 <br />(719)544-0247 <br />RolaF.e.T D. 86e.re.gwt v <br />If you have additional comments and/or information that should be provided to the Division, please provide i[ <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signature of Corporate Officer or Owner <br />_3-/~-0~ <br />Date <br />MIPERMITh1ASTERD000MENTSN4-AF-OI <br />