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• , iii iiiiiiiiuiiiiii <br /> ANNUAL FEE and REPORT REQUEST <br /> PERMITTEENAME: Aspen Enterprises RECEIVED <br /> PERMIT NO.: M-1978-208 JUN 18 2001 <br /> OPERATION NAME: Shaffers Crossing <br /> ANNIVERSARY DATE: June 16,2001 Division of Minerals and Geology <br /> ANNUAL FEE DUE: �)SM00(Due on or before your anniversary date) <br /> COUNTY: /Jefferson <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 <br /> operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br /> land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br /> occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br /> beginning of active operations, and the date active operations ceased for the year, if any. <br /> Please attach your revised written annual report and annual report man to this form. Please note that an <br /> adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: William S. Peterson <br /> Permittee Name: Aspen Enterprises <br /> Address: 12383 Wamblee Valley Road <br /> Conifer, CO 80433 <br /> Phone Number: (303) 670-3160 <br /> Fax Number: <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 <br /> enclosed. <br /> &'� a�<� <br /> Signature of Corpora le Officer or Owner <br /> Date <br /> M'TE RM ITWASTE RDOCUME NTSN-AF-01 <br />