REP21712

• Permit No: M1980052
• IBM Index Class Name: Report
• Doc Date: 3/17/2003
• Doc Name: Annual Report
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~ECEI VED
MAR 112003
~)- _~ivision if Minerals and Geology
PERMITTEE NAME: mid K Holsinger C~~.1~,. ,w ,9E~
PERMIT NO.: M-1980-052
OPERATION NAME: Holsinger Gravel Pit
ANNIVERSARY DATE: April 23, 2003
ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date)
COUNTY: Jackson
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
-shaft-sum a annua ee, a report an map showing The extent of current disturbances to affected-land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased far the year, if any.
Please attach y~rr revised written anneal report and annual reo, nrt m ~n to this Tnrm_ P/ease note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact:
Permittee Name:
Address:
Keith Holsinger
~taRltd K Holsinger
P.O. Box 37
Walden, CO 80480
_-P-hone.Number.- (970)-723-4587 ._
Fax Number: [phone]
If you have additional comments and/or information that should be provided [o the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
t afore of orporate Office weer, or Designee
~~~~Q~
Date~~
M:~PERMn1MASTERD000MENTSU.f-AF-01