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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />• •r `,tea ..,n h~`~'~~ <br />TWK Enterprizes Inc <br />DEC 1 22003 <br />M-1988-090 <br />Deer Trail Pit <br />December 7, 2003 Uiulsion of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Arapahoe <br />r \b <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 />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 y~nnr revised written anneal rennrt and anneal rennrt min to this form. please note that an <br />adequately labeled map that clearly delineates and includes the above elements may Buff ce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Wayne Pipkin <br />Permittee Name: TWK Enierprizes Inc <br />Address: P. O. Box 404 <br /> Byers, CO 80103 <br />Phone Number: (303) 622-9491 <br />Fax Number: (303) 622-9553 <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 />Signature of Cor oral ficer, Owner, or Designee <br />Date <br />M1PERM ITVNASTERDOCUMENTSUI-AF-01 <br />