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IIIllllllllll111111 <br />ANNUAL FEE and REPORT REQUEST <br />RECEIVED <br />PERMITTEE NAME: A.J. Botti Construction & Gravel JAN 0 8 2001 <br />PERMIT NO.: M-1997-027 <br />OPERATION NAME: Moonscape Pit Division of Minerals end Geology <br />ANNIVERSARY DATE: January 30, 2001 <br />ANNUAL FEE DUE: $281.00 (llue on or before your anniversary date) <br />COUNTY: Delta <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 perrnit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accotnpiished to date and during [he preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation [hat will he performed during the corning year, the dates for [he <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 maa to this form. Please note that cm <br />adeyua[e!v labeled reap [ha[ clearly delureales and includes the abore elements nurv srjfrce for n tivrrr[en <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Andy Botti _ <br />Permittee Name: A.J. Botti Construction & Gravel <br />Address: 454 1250 Ur. <br />Delta, CO 81416-9107 <br />Phone Number: (970) 874-8141 <br />Fax Number: ~9~Q~~~y/ <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 <br />enclosed. / <br />Cfi//10U/L~Q p` ~i4~c1 /nti~ :~v o100U w~+/ u~~~+= ~/IOU_gv~s. <br />rgnature Corporate Officer or Owner <br />_~ ~ r~ ~ <br />Date <br />M'~PERMfAMASTERDOCUM1tENTS~A1-AF~U r <br />