2008-03-12_REPORT - M1977392

• Permit No: M1977392
• IBM Index Class Name: REPORT
• Doc Date: 3/12/2008
• Doc Name: Annual Fee/Report/Map
• From: The Denver Brick Company
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DA7,E:
ANNUAL FEE DUE:
COUNTY:
Ate ~P1"
ANNUAL FEE and REPORT REQUEST
/ The Denver Brick Company
~M-1977-392
Dawson Mine
March 11, 2008
.# ~ ,~l~
MAR 12 2008
~)ViBior~ of ~~-amation,
Mining and Safety
$$791.00 (Due on or before your anniversary date)
Elbert
According to C.R.S. 3~4-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
- -=reciam~tion~cc6ttiplis'ned to=dace and during the preceding year; nzw distu~barrces-that-are antieipal~d to-occat- -° --
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, acid the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this form. The Annual Report
& Fee requirement is. not met until we have received the following components: fee, report, and associated
map. If no new disturbances or reclamation have occurred during the previous year and no new chanEes to
the previous year's miap are necessary, then no new map is required, provided that the Operator shall state
this in the Annual Report• Please note that an adequately labeled map that clearly delineates and includes the
above elements may su f ce for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: ~Ebctt~E`.-~'etfipleteri~il cbe,*(- ~,TJ~~NF-ts
Permittee Name: The Denver Brick Company
Address: 4(11 Prairie Hawk Dr.
C;~stle Rock, CO ~~A4 S©l ~~
Phone Number: [phone]
Fax Number: (303) 688-~9~9 8'9~
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
Signature of Co or to Officer, Offer, or Designee
d ~" ~~~
Date