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:a <br />RECEIVED <br />FEB 1 8: 2003 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Summit Brick & Tile Co. <br />M-1977-324 <br />Stocks Clay Mine <br />February 17,2003 <br />$688.00 (Due on or before your anniversary date) <br />Fremont <br />Division of Minerals and Geology <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 ymrr revised written annnal re~pnrt and annual rennrt m,~ to this fnrm_ 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 />~ ~ ~~~~~~ <br />Sign re o 'Corporate Officer, Ow er, or Designee <br />~--~13~z o~.s <br />Date <br />M:~PERMITVv1ASTERD000MENTSUI-AF-01 <br />