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... <br /> <br />• , iii iiiiiiiiiiiiiiii <br />~`~~~~11CaDnd 111 Enclosure <br />Permittee Name: Summit Brick & Tile <br />Permit No: 77-321 f,IAR J 195 <br />Operation Name: Native <br />Anniversary Date: February 17 f•.~INKU LAidD I~(GLA(d~ATIDN DIUISItlN <br />Cdo, Dcp(. n( rdaiural Resources <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />x <br />x <br />Remarks: <br />Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />Pd. - G~¢~k #- <br />~a6yo <br />A). Land affected during 7th year - 1/8 acre. <br />B). Land anticipated to be disturbed during the next year is 1/8 to 1/4 acre. <br />C). No land was reclaimed during the last year. <br /> <br />Signature ~J~segh C. Welte <br />3~6~8s <br />~~ ( C <br />