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<br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Benson Brothers RECEIVED <br />PERMIT NO.: M-1977-062 MAR 2 9 2002 <br />OPERATION NAME: Hallenbeck Pit No 1 Division of Minerals and Geology <br />ANNIVERSARY DATE: April 2, 2002 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY; Delta <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 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 the upcoming year, reclamation that will be performed during [he 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 resort and annual report maa 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 Contac[: Ed Benson <br />Pemtittee Name: Benson Brothers <br />Address: 2134 J-50 Rd. <br />Phone Number: <br />Austin, CO 81410 <br />(970) 835-3128 <br />Fax Number: <br />(970)835-8567 <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 are enclosed. <br />~L- <br />ignature of Corporate Officer or Owner <br />-~-a~lo - y°Z <br />Date <br />M:~PERMn'N1ASTERD000MEMSUI-AF-01 <br />