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~ , ~ ~ IIIIIlIII1111A1lII <br />110 Enclosure <br />Permittee Name: Summit Brick $ Tile ~ ~ ,cc~) <br />Permit No: M-77-321 <br />Operation Name: Native /pier re Mine <br />Anniversary Date: 02/17/89 ,. <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />X Check or money-order payable to-Golora do Mined Land Reclamation <br />Division for annual fees due $50,00 <br />X Annual Report (See Belo+~) <br />Remarks: <br />p) Land affected during 11th year - 0 acres. <br />B), rand anticipated to be disturbed during the next year is 1/8 to 1/4 acre. <br />C). No land was reclaimed during the last year although about 1.6 acres were <br />backfi.lled. <br />Signature <br />(Rev. 06/ <br />0052f <br />C. Welte <br />