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1111111111111 111 � � <br /> aka 1 �gg <br /> 999 <br /> RECEIVED <br /> • ANNUAL FEE and REPORT REOUEST DEC 2 8 20M <br /> c Division of Minerals and Geology <br /> PERMIT-FEE NAME: The Denver Brick Company <br /> PERMIT NO.: M-1996-064 <br /> OPERATION NAME: Stevens Clay Lease <br /> ANNIVERSARY DATE: December 23,2000 <br /> ANNUAL FE'.' DUE: $688.00(Due on or before your anniversary date) <br /> COUNTY: Douglas <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 <br /> operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br /> land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br /> occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br /> beginning of active operations, and the date active operations ceased for the year, if any. <br /> Please attach your revised written annual report and annual report map to this form. Please note that an <br /> adequately labeled inup that clearly delineates and includes the above elements may suffice for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> • changes: <br /> Permittee Contact: Wayne Spence <br /> Permittee Name: The Denver Brick Company <br /> Address: 401 Prairie I-lawk Dr. <br /> Castle Rock,CO 80104 <br /> Phone Number: (303)688-6951 <br /> Fax Number: (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 <br /> enclosed. <br /> ignature6 f CQrpor Officer or Owner <br /> Date <br /> M:TERMrrMASTERD0CUMENTS\M-AF-01 <br />