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.1 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />A UAL SEE and PORT REQUEST <br />Summit Pressed Brick & Tile Co. <br />,,M-1993-080 <br />Calhan Clay Pit <br />Apri126, 2007 <br /> <br /> <br />~~'R ~ 0 2001 <br />Division ai r.~clamafion, <br />Mining and Safety <br />$$688.00 (Due on or before your anniversary date) <br />EI Paso <br />According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-116, each year, on the anniversary date of the pettnit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to 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 your revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />man. If no new disturbances or reclamation have occurred durinti the previous vear and no new chanties to <br />the previous year's map are necessary. then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: 7oseph 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 it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />~ 1~~~ ~ - <br />Si a re f Corporate Officer, Own r, or Designee <br />t-f LG 2vo7 <br />Date <br />