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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Hollenbeck, Inc. <br />M-1985-023 <br />Hollenbeck Pit <br />May 6, 2002 <br />$281.00 (Due on or before your anniversary date) <br />Gunnison <br />RECEIVED <br />APR 2 3 2002 <br />Division of Minerals and Geology <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-submit-the-annual-fee; -a-repoFt-and-map-showing-the-extent`af-current-i"stiurba`nces to affected-land; <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the 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 your revised written annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Gene Hollenbeck <br />Permittee Name: Hollenbeck, Inc. <br />Address: P.O. Box 902 <br />Gunnison, CO 81230 <br />Phone Number: (970) 641-0556 _ <br />Fax Number: <br />-?a <br />If you have additional continents 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 enclosed. <br />Signature of Corporate Officer or Owner <br />7/ l/-2-- <br />Da <br />Exhibit <br />M-\PERM nWASTER DOCU MENCS\M-AF-01