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~~J <br />1 d~ <br />~~~ f~P~' <br />AN1ViiA1, FF.F, and RF,PORT RF.niTF,ST <br />CEI VEU <br />PERMITTEE NAME: Summit Pressed Brick & Tile Co. NOV 1 5 <br />PERMIT NO.: NI-1977-325 ~'J~ 1005 <br />OPERATION NAME: Cherokee Clay Mine V ~i~~s,°n °t Minerals anu heo~e <br />8r <br />ANNIVERSARY DATE: November 23, 2005 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Fremont <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 subm,t--' t i-F e annu`al~"ee, a report-and map showing the extenf"of ouaent~ts-iurliances ~fo affected-land, <br />reclamation accomplished to date and during the 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 xpnr revised written annnal re~nrt and annnal refit m,~ to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following petmittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Joseph C. Welte <br />Permittee Name: Summit Pressed Brick & Tile Co. <br />Address: P.O. Box 533 <br />Pueblo, CO 81002-0533 <br />Phone Number: (719) 542-8278 <br />Fax Number: (719) 542-5243 <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />~! <br />Signa e o Corporate Officer, Own , or Designee <br />~/~j~ ZoO~ <br />Date <br />