REP13741

• Permit No: M1977219
• IBM Index Class Name: Report
• Doc Date: 3/22/2004
• Doc Name: 2004 Annual Report
• From: Summit Brick & Tile Co.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Summit Brick & Tile Co.
M-1977-2I9
Fox No. 1 Clay Pit
March 22, 2004
MAR 2 2 2004
BiYision ~f Minerals and Geology
$688.00 (Due on or before your anniversary date)
Pueblo
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 accom~lished_to date and during_the preceding_yea, 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 ynnr revised written anneal re~prt and anmral re`nrt maTtn 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: Joseph C. Welte
Permittee Name: Summit Brick & Tile Co.
Address: P.O. Box 533
Pueblo, CO 81002-0533
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. Annua] Report instructions are enclosed.
Sign„ re f Corporate O facer, Owne , or Designee
~~~~ ,
Date