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., , <br />.~ y <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Alpine Rock Company <br />M-1993-035 <br />Swan River Resource <br />October 4, 2003 <br />$688.00 (Due on or before your anniversary dategn of Minerals and Geology <br />Summit <br />~~~~IVED <br />ocro3~~ <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 />sfiall submit tlTe annual -fee, a report and mahsp owrng the extent of current d~`sturbances to affected-land,-- <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during [he 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 ynnr revised written anneal report and anneal rennrt 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 report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Gregory Z. Gerganoff <br />Permittee Name: Alpine Rock Company <br />Address: 14802 W. 44th Ave. <br />Golden, CO 80403 <br />Phone Number: (303) 279-6611 <br />Fax Number: (303) 279-6216 <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 />~~ <br />Signature of Corporate Officer, Owner, or Designee <br />9- 2 T~~ 3 <br />Date <br />M:\PERMITU-IASTERDOCUMENTS\M-AF-01 <br />