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%c <br />RECEIVED <br />A>`nviiAi, FF.F, and RF.Pt7RT RF.niTFST FEB 1.9 2004 <br />Division of Minerals & Geelopy <br />PERMITTEE NAME: Summit Brick & Tile Co. <br />PERMIT NO.: M-1977-321 <br />OPERATION NAME: Native/Pierre Mine <br />ANNIVERSARY DATE: February 17, 2004 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Pueblo <br />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 <br />shall-submit-the-annual-fee,-a-report and-map showing the-extent of current disturbances to "affected-land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written anneal re~prt and anneal rennrt m~tn this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Joseph C. Welte <br />Permittee Name: Summit Brick & Tile Co. <br />Address: P. O. Box 533 <br />Pueblo, CO 81002-0533 <br />Phone Number: (719) 542-8278 <br />Fax Number: (719) 542-5243 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />~ ~~~~ p <br />Officer, O~Jrler, or Designee <br />Date <br />MiPERMITMASTERDOCUMENTSIM-AF-01 <br />,, `~~6~ <br />~,JNl1~L FF,~ wt4'S SN i ®~ 2~l ~%y <br /> <br />