2006-04-12_REPORT - M1993004

• Permit No: M1993004
• IBM Index Class Name: Report
• Doc Date: 4/12/2006
• Doc Name: Annual Fee/Report/Map
• From: Robinson Brick Company
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
~/ ANNTiAT. FF.F. and RF.P(1RT RF.niiF,ST
/ Robinson Brick Company
M-1993-004
Navajo Clay Pit
May 10, 2006
$688.00 (Due on or before your anniversary date)
Elbert
REC~~~~~~7}
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r/ Oi~isioo of Minerals and pnolapy
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
- shall submit the annual -fee; a report and map showing the ezteni of~currerif disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
-- -during-the-upcoming-year,-reclamation that-will-be performed during the coming year, the dates for the begittning
of active operations, and the date active operations ceased for the year, if any.
Please attach ymrr revised written annual report and anneal rennrt m ~n to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Marvin R. (Ric) Myers, Jr.
Permittee Name: Robinson Brick Company
Address: Mining Deparhnent
1845 W. Dartmouth Ave.
Denver, CO 80110-1308
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
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Signature of Corporate ffi •, Owner, or Designee
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