2005-06-20_REPORT - M1982086

• Permit No: M1982086
• IBM Index Class Name: Report
• Doc Date: 6/20/2005
• Doc Name: Annual Fee/Report/Map
• From: alpine rock company
• To: dmg
• Media Type: D
• Archive: No

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PERMITTEE NAME: Alpine Rock Company
PERMIT NO.: M-1982-086 JUN 2 p 2005
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OPERATION NAME: Fairplay Site ~~~"~Qf
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ANNIVERSARY DATE: June 11, 2005
ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date)
COUNTY: Park
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 anmial 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 ynnr revised written annual re~nnrt and annnal report m,~ to this form- Please note that an
adequately labeled map that clearly delineates 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:
Permittee Contact: Greg Gerganoff
Permittee Name: Alpine Rock Company
Address: 14802 W. 44th Ave.
Golden, CO 80403
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
Officer, Owner, or Designee
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Date