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• • iii iiiiiiiiiii iii <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date: <br />Summit Brick & Tile <br />M-77-321- <br />NATIVE/PIERRE MINE <br />02/17/86 <br />RGV~~'~! f6~i'nd 111 Enclosure <br />MAR 51986 <br />M1NED I.AfVD R~;[,At~gATiDN <br />Calo. Dept. of Natural pesourcos <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 Colorado Mined Land Reclamation <br />Division for annual fees due <br />x Annual Report <br />Remarks: <br />A). Land affected durinq 8th year - 1/8 acre. <br />R). band anticipated to be disturbed durinq the next year is 1/8 to 1/9 acre, <br />C). No land was reclaimed durinq the last year, <br />Signature <br />Joseph C. Welte <br />3~~ /£~6 <br />~, sB. ~ <br />,~; l c, <br />_~ <br />