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<br /> <br />ANNUAL REPORT <br />PERMITTEE NAME: Lakewood Brick & Tile Company <br />PERMIT NO.: M-1975-009 <br />OPERATION NAME: Doughty's Pit <br />ANNNERSARY DATE: September 30, 2000 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $281.00 <br />COUNTY: Jefferson <br />REC:FINED <br />SEF' 2 1 2000 <br />Division of Minerals z^d GealogY <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the perniit, an operator shall <br />submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that :Ire anticipated <br />to occur during the upcoming year, reclamation that will be performed during the coming year, the <br />dates for the beginning of active operations, and the date active operations ceased for thl: year, if any. <br />Please attach your revised annual report map and written report to this annual reuort. Please <br />note that an adequately labeled map that clearly delineates and includes the above elements may <br />suffice for n written report. <br />Please type or print the current contact person's name, mailing address, and phone numt~er in the space <br />provided: <br />Contact Name: Thomas J. Murray Company: Lakewood Bricl: & Tile Cc. <br />Address: 1325 Jay Street Phone No.: (303 ) 238-5313 <br />Lakewood, CO. 80215 FAX No.: ( 303) 237-7't37 <br />e-mail: <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />9/19/00 <br />Date <br />INSTRUCTIONS ON BACK <br />A7. W ERAIFMIASTERDOCUAIEKr$U7-AF-01 <br /> <br />