2001-03-22_REPORT - M1977219

• Permit No: M1977219
• IBM Index Class Name: Report
• Doc Date: 3/22/2001
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST
RECEIVED
PERMITTEE NAME: Summit Brick &Tile Co.
PERMIT NO.: M-1977-219 MAR 21 2001
OPERATION NAME: Fox No. 1 Clay Pit Division of Minerals and Geology
ANNIVERSARY DATE: March 22,2001
ANNUAL FEE DUE: $688.00(Due on or before your anniversary date)
COUNTY: 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 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 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 annual report and annual report man to,this form.- Please note that an
adequately labeled Wrap 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.
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SignatV of dorporate Officer or Owner
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Date
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