2005-10-14_REPORT - M1989052

• Permit No: M1989052
• IBM Index Class Name: Report
• Doc Date: 10/14/2005
• Doc Name: Annual Fee/Report/Map
• From: Acme Brick Company
• To: DMG
• Media Type: D
• Archive: No

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PERMITTEE NAME: r~ Denver Brick Company OCT 1 42005
PERMIT NO.: ~M-1989-052
Division of Minerals and GsoloGY
OPERATION NAME: Dakota Clay Pit
ANNIVERSARY DATE: October 25, 2005
ANNUAL FEE DUE: $281.00 (Due on or before your a nniversary date)
COUNTY: Jefferson
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
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach~mrr revised written annnal report and annual rennrt man to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Albert Templeton
Permittee Name: G vwe ~ c H
Address: C/O Acme Brick -Denver
401 Frairie Hawk Dr.
Castle Rock, CO ~Ok04 ~ O / b 9
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
of Corporate
or Designee
Date