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iii iiuiiiiuiiiiii ~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />TWK Enterprizes Inc <br />M-1988-090 <br />Deer Trail Pit <br />December 7, 2001 <br />RECEIVED <br />DEC 10 2001 <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Arapahoe <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 />shall submit the annual fee, a report and map showing [he extent of current disturbances to affected land, <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 your revised written annual report and annual repots mao 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: Wayne Pipkin <br />Permittee Name: TWK Enterprizes Inc <br />Address: P.O. Box 404 <br />Byers, CO 80103 <br />Phone Number: (303) 622-9491 <br />Fax Number: _ (303) 622_955.3 , <br />If you have additional comments and/or information [hat should be provided [o the Division, please provide i[ <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signature of o orate O icer or Owner <br />_/~ - 7- ~/ <br />Date <br />M: W ER M ITh1 A ST E R DOC U M EM SN1 ~ AF ~01 <br />