2006-05-10_REPORT - M1985203

• Permit No: M1985203
• IBM Index Class Name: Report
• Doc Date: 5/10/2006
• Doc Name: Annual Fee/Report/Map
• From: Summit Brick & Tile
• 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:
r
C/ ANNTiAT, FF.F, and RF.Pt1RT RF. TiF,ST
~ Summit Brick & Tile Co. REL+E1~
~M-1985-203 u I/1-nne~D
Edmondson Clay Mine ~~ ~ ~ 2vup
vDivision of Minerals end Geoleg~
May 9, 2006
$281.00 (Due on or before your anniversary date)
Pueblo
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 I
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reclamation accomplished_to.date and_during_the-preceding-year; new-disturbances that are anticipated-to occur==_- I
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 ym~r revised written annnal re~7nrt and anm~al rennrt mqp to this Fnrm_ 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: Joseph C. Welte
Permittee Name: Summit Brick & Tile Co.
Address: P.O. Box 533
Pueblo, CO 81002-0533
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.

Officer,~Owner, or Designee
Z~J~
Date