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1~- <br />RECEIVED <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 />JUL 2 9 2002 <br />Division otMinerala and Geology <br />Fred L Korinek <br />M-1979-131 <br />Korinek S & G Pit <br />July 27, 2002 <br />$281.00 (Due on or before your anniversary date) <br />Crowley <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 cnhmitlhe_annual~ee,_a_[epor[_and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that aze anticipated to occur <br />during the upcoming yeaz, 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 man to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Fred L. Korinek <br />Pennittee Name: Fred L Korinek <br />Address: 550 Lane 15 <br />Manzanola, CO 81058 <br />Phone Number: (719) 254-7271 <br />Fax Number: <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 aze enclosed. <br />.~-~-c-. <br />Signature of Corporate Officer or Owner <br />~ -,~ v -a z <br />Date <br />M:~PERMI'nMASTERDOCUMENT5U1-AF-01 <br />