REP31385

• Permit No: M1977317
• IBM Index Class Name: Report
• Doc Date: 12/16/2003
• Doc Name: 2003 Annual Report and Fee
• From: Summit Brick and Tile Co.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Summit Brick and Tile Co.
M-1977-317
Cedarwood Clay Mine
December 15, 2003

RECE-~Ef~
DEC ~ 6 2003
~on~fMlnarels and QeoloOY
$281.00 (Due on or before your anniversary date)
Pueblo
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 operatQr__-
shall submit the annual_feeTa_report-and-map-showing-the-ex~en o~disturbances to affected land, _
_ -reclamation accomplished to-date and-during tfie preceding year-, new disYurtiances that are anticipated to occur J
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written anneal rennrt and anneal rennrt m ~n to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Joseph C. Welte
Permittee Name: Summit Brick and Tile Co.
Address: P. O. Box 533
Pueblo, CO 81002-0533
Phone Number: [phone]
Fax Number: [phone]
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.
Signatu o Corporate Officer, O ter, or Designee
y-/Z -~~
Date
M:~PERMITU-IASTERDOCUM ENTSVN-AF-01