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WEE" <br />9 <br />PERMITTEE NAME:I'h enver Brick Company �JZCEIVED <br />PERMIT NO.: (iNi-1997-007 EB Z 3 2010 <br />OPERATION NAME: Bijou Clay Mine Division of Recipmatlaq, <br />Mining a SO* <br />ANNNERSARY DATE: February 19, 2010 <br />ANNUAL FEE DUE: $5791.00 (Due on or before your anniversary date) <br />COUNTY: Elbert <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 />PlWe attach your revised written annual report and annual revort main to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fm reuoM and awociated <br />an If no new disturbances or reclamation have occurred durin the previous year and no new chances to <br />the vMjous year's way are necessary, then no new may is required, vided that The Overator 1hall. tat <br />this in the Anupal 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 />Permittee Contact: Robert D. Tibbetts <br />Permittee Name: The Denver Brick Company <br />Address: 401 Prairie Hawk Dr. <br />Castle Rock, CO 80109 <br />Phone Number: (303) 688-6951 <br />Fax Number: (303) 688-9894 <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 />Si ature oto rn orate Officer, Owner, or Designee <br />gn rP <br />Dat6/ a4 <br />