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f,Gt-' <br /> ~~-~- RP ~ <br /> ANNUAL FEE and REPOR <br />REOUEST <br />T <br />PERMITTEE NAME: ~ <br />p <br />Alpine Rock Company ~` <br />PERMIT NO.: M-1993-035 (:/ <br />OPERATION NAME: Swan River Resource <br />ANNNERSARY DATE: October 4, 2007 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Summit <br />RECEIVED % ~ <br />OCT 012007/~~ <br />Division of ReGamation, 7j' <br />Mining and Safety t/ <br />According-to C-.R;S-34-32-5-I-16-orC:R:S-34-32-1-i&~ach-year,-on-the anniversary date~of-the perrrcit,-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 your revised written annual report and annual report maa to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred durinc the previous year and no new chances to <br />the arevious year's man are necessary. then no new mau is required, arovided that the Ouerator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: ,~egetq~-6~ganoff <br />36g Srl3.t,~nt~ <br />Permittee Name: Alpine Rock Company <br />Address: 14802 W. 44th Ave. <br />Golden, CO 80403 <br />Phone Number: (1~3~-2~9-H611 ~~S41 ]21ie <br />Fax Number: (303) 279-6216 <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />1 '~ J'~ <br />Signature of Corporate Officer, Owner, or Designee <br />Date <br />