2006-12-18_REPORT - M1996064

• Permit No: M1996064
• IBM Index Class Name: Report
• Doc Date: 12/18/2006
• 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

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
,~ ANNUAL FEE and REPORT REQUEST
V The Denver Brick Company
/M-1996-064
Stevens Clay Lease
December 23, 2006
12,I~r-v
RECE~1iFD
DEC 181006
~ivision of Reclamation,
Mining and Safety
$$688.00 (Due on or before your anniversary date)
Douglas
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-I 16, 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,
-~c.clamation-accompiished'to-date and-during-the preceding year, new disturbances that are anticip`ated-to-occur ----'
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 annual resort and annual report map to this form. The Auuual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
maa. If no new disturbances or reclamation have occurred during the arevious year and no new changes to
the previous year's map are necessary, then no new maa is required, urovided that the Oaerator shall state
this in the Annual Resort. Please note that an adequately labeled map that clearly delineates and includes the
above elements may since for a written report.
Division records indicate the following petrnittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Albert Templeton
Permittee Name: The Denver Brick Company
Address: 401 Prairie Hawk Dr.
Castle Rock, CO 80104
Phone Number: [phone]
Fax Number: [phone]
If you have additional comment d/or information that should be provided to the Division, please provide
below or attach it to this form alon ith your written report and map. Annual Report instructions are enclosed.
of Corporate Ofjfc~{, Owner, or Designee
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Date