2005-07-13_REPORT - M1984076

• Permit No: M1984076
• IBM Index Class Name: Report
• Doc Date: 7/13/2005
• Doc Name: Annual Fee/Report/Map
• From: robinson brick company
• To: dmg
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNTiAi, FF.F, and REPORT RF.nTIFST
Robinson Brick Company
M-1984-076
DDD
August 9, 2005
~~~~i~ ~6
JU( 7 3 2005
Division aI htirerals & CcoloyY
$688.00 (Due on or before your anniversary date)
Elbert
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
--- sh~l`submit the annual-fee,-a report and-map-showing-the-extent-of-current--disturbances-ko-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 beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach ynnr revised written anmial re~nrt and annnal red nrt main in 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 ;md make any necessary
changes:
Permittee Contact: Marvin R. Myers, Jr.
Permittee Name: Robinson Brick Company
Address: 1845 W. Dartmouth Ave.
Denver, CO 80110-1308
Phone Number: (303} 783-3046
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Di~rision, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
Signa re of Corporate Officer, O e , esignee
_7 ! yr
Date