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Permittee Contact: Sue Pipkin <br />Permittee Name: <br />Address: <br />11 <br />Date <br />TWK Enterprises, Inc. <br />P.O. Box 404 <br />Byers, CO 80103 <br />Signature of Co orate Officer, Owner, or Designee <br />ANNUAL F <br />EE and REPORT REQUEST <br />PERMITTEE NAME: WK Enterprises, Inc. <br />PERMIT NO.: (VI 1988 -090 <br />OPERATION NAME: Deer Trail Pit <br />ANNIVERSARY DATE: December 7, 2011 <br />ANNUAL FEE DUE: <br />COUNTY: <br />$$791.00 (Due on or before your anniversary date) <br />Arapahoe <br />tiz telle <br />DEC 022011 <br />Division ofRecia <br />Mining & Safety <br />UOp <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_ 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 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 year 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 suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Phone Number: '(303) 622 =9491' 3 8)=1 - % '7 a 1 <br />Fax Number: 43-03) 5'3' <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 />