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<br />t/ ANNUAL FEE and REPORT REQUEST <br />~~-~ <br />PERMITTEE NAME: ~ Summit Brick & Tile Co. ^ r ~'~ <br />l <br />/ r <br />PERMIT NO.: / M-1477-321 / Fr='~ 9 ~ ;r~`~7 <br />r, . , <br />OPERATION NAME: Native/Pierre Mine Or , „ , <br />ANNIVERSARY DATE: February 17, 2007 ,~~"> <br />ANNUAL FEE DUE: $$281.00 (Due on or before your anniversary date) <br />COUNTY: Pueblo <br />m~ <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 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 vour revised written annual report and aunual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, resort, and associated <br />ma If no new disturbances or reclamation have occurred during 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 Anuual 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: Joseph C. Welte <br />Permittee Name: Summit 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 <br />below or attach it to this form along with your written report and map. <br />~~ ~~~~ <br />Signa e o Corporate Officer, Ow er, or Designee <br />2 ~l~~zvo 7 <br />Dat~ <br />provided to the Division, please provide it <br />Annual Report instructions are enclosed. <br />