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<br />RECEI VE® <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Avalanche Creek Marble & Alabaster LLC <br />M-1999-042 <br />White Banks Mine <br />January 4, 2003 <br />$225.00 (Due on or before your anniversary date) <br />Pitkin <br />DEC 3 11ppT <br />Divisipa of blis8tals and Geplpgy <br />According to C.R.S. 34-32.5-ll6 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing [he extent of current disturbances to affected <br />~- land, reclamation accomplished to date and during t'he preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during [he coming year, the dates for [he <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Pl ac a ach your revised written annnal report and anmia] report m to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permiuee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Thomas Swint <br />PetTnittee Name: Avalanche Creek Marble & Alabaster LLC <br />Address: 2211 Banbury Rd. <br />Inverness, CO 60067 <br />L IIC l2 n/~ S~ , ~L ~ a ob <br />__ . _Phone Number: (847) 358-3834 _ _ _ _ _ _ <br />Fax Number: (970) 257-9847 s! N ~ - "7 7 r; - 2-b d <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 <br />enclosed. <br />S cure of Corporate Officer, Owner, or Designee <br />Date T <br />M'.W ERMI7IMASTERDOC UMENTS/M-AF-02.DOC <br />