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:.. <br />r/ <br />PERMITTEE NAME: H & H Stone <br />PERMIT NO.: M-1998-080 <br />OPERATION NAME: H & H Quarry #2 <br />ANNIVERSARY DATE: November 27, 2003 <br />iii, ;-~~6.~ ~ <br />OCT ' 1' ZQ~~ <br />9ivisian o/ Mlnerzle - . <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Dolores <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 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 ~nr revised written anneal rennet and anneal rennet maw to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffrce 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 Holley <br />Permittee Name: H & H Stone <br />Address: P.O. Box 250 <br />Dove Creek, CO 81324 <br />Phone Number: (970) 677-2767 <br />Fax Number: ^ (970) 677-2921 <br />~(Ar-~ <~_o ~~L~-~~ <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 />Signature of Corporate Officer, Owner, or Designee <br />Date <br />M: tPERMIrU1ASTERDOCUMENTSIM-AF-01 <br />