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~,.- ~ -- - <br />~ ~ ~ ANNUAL REPORT <br />PERMITTEE ~ ME: Summit Brick and Tile Co. F~ECF_~!/~Q <br />PERMIT NO.: M-77-317 <br />OPERATION NAME: Cedarwood Clay Mine I- - y ~~ '""'' <br />C : ~: ~~ cl n7marah 8 Geology <br />ANNIVERSARY DATE: December 15, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 <br />COUNTY: Pueblo <br />According to C.R.S. 34-32.5-116(3)(a), each yeaz, 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 <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginning of active operations, and the date active operations ceased for the year, <br />if any. <br />Please attach vour revised annual report map and written report to this annual report. Please <br />note that an ndequntely labeled rnnp that clem'ly delineates and inc6~des the above elements nmy <br />suffice for n written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name:~~1 ~sr~f>< G (~F L-Tf <br />Adddress: U', ~r ~ OX 5,3~ <br />At~Fif LO, CO Shod oS33 <br />Company: ,Sy/Pl/!1/T-~~c /GG,(( ~T/G~ ~o, <br />Phone No.: (7/~ ~~~ ` 0 ~ 7~ <br />Fax No.: (7/y) ~~a ~ s ~ y3 <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 />report. <br />~ ~ zi T <br />Signa r of otporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />