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~e <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />The Denver Brick Company <br />M-1997-007 <br />Bijou Clay Mine <br />February 19,2004 <br />$688.00 (Due on or before your anniversary date) <br />Elbert <br />FEB 1.9 2004 <br />Division of Minerals & 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 />a -anneal-fee; a-repart--arid-mep-chewing-the-e~xte-nt-ef-current-distucbances~o_affectPCl 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 ynpr revised written anmial report and anneal re; nn rf mate to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Charles Platt <br />Permittee Name: The Denver Brick Company <br />Address: 401 Prairie Hawk Dr. <br />Castle Rock, CO 80104 <br />Phone Number: (303) 688-6951._ <br />Fax Number: (303) 688-5270 <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 formal g with your written report and map. Annual Report instntctions are enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />-/?-a~ <br />Date <br />M:IPERMITMASTERDOCUMEMSIM-AF-01 <br />