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Permittee Name: <br />Permit No: <br />Operation Name: <br />Aaniversary Date: <br />L?llCewood Brick and Tile Co. <br />M-79-045 <br />Church Pit <br />02/28/94 <br />pCnC~.'_rl <br />~-- J~ <br />FEB 25 1994 <br /> <br />Page 3 <br />The effective date of all information contained herein is <br />February 9th, 1994. Enclosed is the Annual Report, Annual Report <br />Map, and a check for $550.00 to cover the Annual Fee. Please sign <br />below to indicate your receipt of this Annual Report, Map and the <br />Annual Fee. Please return it to Environment, Inc., at 7985 Vance <br />DR., Suite 205A, Arvada, CO 80003. <br />Respectfully Submitted, <br />LAKEWOOD BRICK AND TILE COMPANY <br />K• <br />.James R. Murray, <br />President <br />RECEIPT <br />RECEIVED this day of FEBRUARY , 1994 <br />Annual Report, Annual Report Map and Check <br /># from Lakewood Brick and Tile Company. <br />By <br />MINED LAND RECLAMATION <br />cc Charles McKay <br />Perry McKay <br />Siri Olsen, Fleming, Pattridge & Runnerstrom <br />Karen Helner, Jefferson County Planning <br />Al Frei & Jim Kilgroe, Coal Creek Sand and Gravel <br />Steve O'Brian, Environment, Inc. <br />File <br />