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.~ ~ , iii iiiiiiiiniii iii <br /> <br /> <br />Permit No: 77-324 sT,xlcs <br /> f'Ii~EO LAND REC! "wiATI0i~1 DI~!IStOtI <br />Anniversary Date: February 17 of i~laiural Resources <br />Oen~ <br />l <br />C <br /> . <br />e. <br />e <br />Operator: Summit Brick & Tile <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />Check or money order payable to the Colorado Mined Land <br />~ Reclamation Division for annual fees due <br />Annual Report <br />xx <br />Remarks: <br />A). During the 6th year there was about '; acre disturbed. <br />B). It is estimated that about '; acres will be disturbed during the next year. <br />C). No land was reclaimed during the last year of operation. <br />THE Su~M7IT BRICK & TILE COA'1PAD1Y <br />Signature ( / Joseph C. Welte <br />~'/~°% <br />0~ 'F~' <br />~i(e <br />