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a . - <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Robinson Brick Company <br />M-1991-003 <br />Tomahawk Mine <br />Apri126, 2003 <br />$688.00 (Due on or before your anniversary date) <br />Pueblo <br />RECEIVED <br />APR 2 3 2003 <br />Division •f Minerals and Geology <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 accomplisfied to date and"during"tfie 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 ynnr revised written annnal report and anm~al rennrt man to this form- please note that an <br />adequately labeled map that clearly delineates and includes the 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: n.~~~~-°-T~c:~:c.`. <br />Permittee Name: Robinson Brick Company <br />Address: 1845 W. Dartmouth Ave. <br />Denver, CO 80110-1308 <br />Phone Number: ~3A3}3$3~04~ <br />Fax Number: -(3A3}~84-~i8-1$ <br /> <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 />Suture of Corporate Off er, ner, or Designee <br />~~/ ~~03 <br />Date <br />M iPERMI7UTASTERD000M ENTSVvt-AF-01 <br />