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ri .. <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />The Denver Brick Company <br />M-1977-392 <br />Dawson Mine <br />March 11, 2002 <br />RECE~~rED <br />MAR f 121611 <br />Division o/Minerals and CeoloBY <br />$688.00 (Due on or before your anniversary date) <br />Elbert <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 [he annual fee, a report and map showing the extent of current disturbances to affected land, <br />------ reclamariori'accomplistied'to-date an8-during-tlie-prisczdirg-year,-~w-disturbancey that"atz-eittici~ateu to'occw'-~~ <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 your revised written annual report and annual report map to this form. 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 petmittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Wagne-Spence <br />Permittee Name: The°Bett9er 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 />Ca rV y /h 2S <br />i <br />~Crne ~I~ifl<. CO. <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 />or Owner <br />~ ~-f <br />Date <br />M 1PERM ITUtASTERDOCUMENTSVvI-AF-01 <br />