2004-09-29_REPORT - M1993035

• Permit No: M1993035
• IBM Index Class Name: Report
• Doc Date: 9/29/2004
• Doc Name: Annual Fee/Report/Map
• From: Alpine Rock Company
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Alpine Rock Company
M-1993-035
Swan River Resource
October 4, 2004
$688.00 (Due on or before your anniversary date)
Summit
SEP 2 9 2004
Division of Minerals & Geology
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,
reclamationaccomplished-to-date:-and-during=the preceding-year,--new disturbances that=are anticipated-to occur= ~-
during the upcoming yeaz, 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 your revised written annual reQ~rt and anmral report map M 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: Gregory Z. Gerganoff
Permittee Name: Alpine Rock Company
Address: 14802 W. 44th Ave.
Golden, CO 80403
Phone Number:
Fax Number:
[phone]
[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.
Si~ure of Corporate Officer, Owner, or Desk
Zc Kati
Date