2003-12-17_REPORT - M1996064

• Permit No: M1996064
• IBM Index Class Name: Report
• Doc Date: 12/17/2003
• Doc Name: Annual Fee/Report/Map
• From: DMG
• To: The Denver Brick Company
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
The Denver Brick Company
M-1996-064
Stevens Clay Lease
December 23, 2003
$688.00 (Due on or before your anniversary date)
Douglas
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-tha-anrmat-fee,-a-repori and~nap-shaving-the ~rrrem-of-current-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 beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written anneal rennrt and anm~al refit m ~n in this form- Please note that an
adequately Labe/ed 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:
Petmittee Contact: Phil McCoy
Permittee Name: The Denver Brick Company
Address: 401 Prairie Hawk Dr.
Castle Rock, CO 80104
(',y~ac~es pl~~t'
~cw.t? ~c~ck - ~e~~eC
-~ 3 0
Fax Number: [phone]
If you have additional comments and/or information [hat should be provided to the Division, please provide it
below or attach i[ to this forrlZalong with your written report and map. Annual Report instructions are enclosed.
Signature of Corporate
12-/~-v3
Date
Owner, or Designee
M:\PERM ITVNASTERDOCUMENTSVN-AF-01