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,.~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br /> <br />ANNUAL FEE and REPORT REQUEST <br />Anthony Zellitti <br />M-1980-246 <br />Zellitti Pit <br />February 28, 2002 <br />RECEIVED <br />FEB t 5 2002 <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />La Plata <br />According to C.R.S. 34-32.5-I 16 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 [he 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 inap that clearly delineates and includes the above elements may suffice for a written report. <br />Dwision records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Anthony Zellitti <br />Permittee Name:. Anthohy Zellitti <br />Address: 2001 CR 300 <br />Durango, CO 81301 <br />Phone Number: (970) 247-3834 ~/ p <br />Fax Number: rq.~\~i X i/ ~ ~r~ _ 9~D "Jrlp3 - Toz 3 C~ <br />If you have add\itillonal comments'a'nTd/Jo`rnformation that should be provided [o the Division, please provide it <br />below or attach it [o this form along with your written report and map. Annual Report instructions are enclosed. <br />SiSrta[ure of ate Officer or Owner <br />2~~ ~ / -, <br />ate <br />M:~PERM mMASTERDOCl1MENTSNr-AF-01 <br />