2002-12-11_REPORT - M1988090

• Permit No: M1988090
• IBM Index Class Name: Report
• Doc Date: 12/11/2002
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
RECEIVE©
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
TWK Enterprizes Inc
M-1988-090
Deer Trail Pit
December 7, 2002
DEC 1 1.2002
Division of Minerals and Geology
$688.00 (Due on or before your anniversary date)
Arapahoe
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
shall submit the annual fee, a report and 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 for the year, if any.
Please attach vour revised written annual report and annual report map to this form. Please note that an
adequately labeled map that clearly de{ineates 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:
Petmittee Contact:
Permittee Name:
Address
Phone Number:
Fax Number:
Wayne Piplcin
TWK Enterprizes Inc
P.O. Box 404
Byers, CO 80103
[phone]
[phone]
If you have additional comments andfor information that should be provided to the Division, please provide it
below or attach i[ to this form along with your written report and map. Annual Report instructions are enclosed.
t
Signature of C rpora Officer, Owner, or Designee
Date
M?PERMITU1A57ERD000MENTSVv1-AF-01