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JAN-O7-2009 02:53PM FROM-DIV RECLAMATION MINING & SAFETY +3038328106 T-937 P.002/002 F-628 <br />I .J <br />and'RCPORf RE VEST <br />AriNUAfL FEE <br />PERMITTEE NAME: he Denver Brick Company /I VICEI D <br />PERMIT NO.- " M-1997-007 Y <br />FEB 2 U bb, <br />OPERATION NAME: Bijou Clay Mine <br />Division of Reclamation, <br />ANNIVERSARY DATE: February 19.2009 Mining and safety <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Elbert <br />According to C.R.S. 3432.5-116 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 />C>/./- <br />please attach your revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fcc re o and associated <br />ma . If no new disturbances or reclamation have occurred during the previoussyear and no new changes to <br />the previous ear's may are necessa then no new ma is re uired rovided that the Operator shall state <br />this in the Annual Re ort. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />Division records indicate the followin8 permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact. Robert D. Tibbetts <br />Permittee Name: The Denver Brick Company <br />Address: 401 Prairie Hawk Dr- <br />Castle Rock, CO 80109 <br />Phone Number: (303) 688-6951 <br />Fax Number: (303) 688-1894 <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 />Signature of Corporate Officer, Owner, or Designee <br />Dat