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fI <br />III IIIIIIIIIIIII III <br />999 <br />~, <br />Permit No: 77-322 sEAVII2 <br />AP~~ ~~) 19~-I <br />Anniversary Date: February 17 ~ff~'ED LAP!U RECLAMATIDid DNISIOtI <br />Colo. Dept, of ~!atural Resources <br />Operator: <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />Check or money order payable to the Colorado Mined Land <br />~ Reclamation Division for annual fees due <br />Annual Report <br />xX <br />Remarks: <br />A). During the 6th year there was about ?, acre disturbed. <br />B). It is estimated that about ~ acres will be disturbed during the next year. <br />C). No land was reclaimed during the last year of operation. <br />TI-IE SiIMMIT BRICK & TILE COMPANY <br /> <br />Signatures / r <br />l / Joseph C. Welte <br />Y~/~o/Jry <br />j ;~~ <br />_~ <br />