REP39744

• Permit No: M1982086
• IBM Index Class Name: Report
• Doc Date: 5/30/2003
• Doc Name: Annual Report
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:

Alpine Rock Company
M-1982-086
Fairplay Site
June 11,2003
RECEIVED
MAY 3 ~ 2003
Division ~f Minerals and Geology
$688.00 (Due on or before your anniversary date)
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 annual fee, a report and_m_ap showing the extent of current disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipate to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates fort beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach ynnr revised written annual report and annual rennrt m ~ to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact:
Permittee Name:
Address:
Phone Number:
Fax Number:
Greg Gerganoff
Alpine Rock Company
14802 W. 44th Ave.
Golden, CO 80403
[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.
Signa e of Corporate Officer, Owner, or Designee
Date
M:\PERM n Vvl ASTERDOCUM ENTSU~7-AF-01