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v <br />RECE11/E® <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />The Denver Brick Company <br />M-1997-007 <br />Bijou Clay Mine <br />February 19, 2003 <br />FEB 14 2003 <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />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 aze 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 anneal rennrt and anneal re nn rt man to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following pemuttee contact information. Please verify and make any necessary <br />changes: /~ / <br />Permittee Contact: Hai~iat's• / ~//~.~' ~~ <br />Pennittee Name: The Denver Brick Company <br />Address: 401 Prairie Hawk Dr. <br />Phone Number: <br />Fax Number: <br />Castle Rock, CO 80104 <br />(303)688-6951 _ <br />(303)688-5270 <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 />-~~~cC~..-. <br />Signature of Corpo to Officer, Owner, or Designee <br />15~- 63 <br />Date <br />M:~PERMITMASTERD000MENTSVN-AF-01 <br />r <br />