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~-- <br />aF ~ RPM <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPOQR~T~REQUEST <br />TWK Enterprises Inc ~/ <br />M-1988-090 ,/ <br />Deer Trail Pit <br />December 7, 2007 <br />$$791.00 (Due on or before your anniversary date) <br />Arapahoe <br />r <br />~~~ <br />!~/1 ~~~~~ <br />/iy~~9' a~~~ ~ a ~~ <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 the extent of current disturbances to affected land, <br />_ __ reclamation ac~mnlished._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 report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous vear and no new changes to <br />the- previous year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since 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 P'pkin ,/~ <br />Permittee Name: TWK Enterprises Inc <br />Address: P.O. Box 404 <br />_- _ Byers, CO 80103 ~ - " - - -- _ _ _ <br />Phone Number: (303) 622-9491 <br />Fax Number: (303) 622-9553 <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 />yam. ~ ,- <br />Signature of Co rate Officer, Owner, or Designee <br />Date <br />