REP24834

• Permit No: M1980052
• IBM Index Class Name: Report
• Doc Date: 3/15/2002
• Doc Name: 2002 Annual Report
• From: F and K Holsinger
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
MAR 1 52002
Division of Minerals and Geology
F and K Holsinger
M-1980-052
Holsinger Gravel Pit
April 23, 2002
$251.00 (Due on or before your anniversary date)
Jackson
According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-I 16, each year, on the anniversary date of the permit, an operator
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reclamation accornplishetl`to thate=atid'durlilg the-precedingyar, new'di'sturbances-rhat'are-a[iiicipafe~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 for the year, if any.
Please attach your revised written annual resort and annual report map to this form. Please note that an
adegaately labeled map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Keith Holsinger
Permittee Name: F and K Holsinger
Address: P.O. Box 37
Walden, CO 80480
Phone Number: [phone]
Fax Number: [phone] ~ _ _ _ -.
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
Si nature of Corporate Of 1 e or Owner
~3~/3~0~
Date
M:NERMrM1ASTERD000MENTSU1-AF-01