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• <br />... <br />ANNUAL REPORT <br />PERMITTEE NAME: Summit Brick & Tile <br />PERMIT NO.: M-77-320 <br />OPERATION NAME: 8-Mile Clay Mine <br />ANNIVERSARY DATE: June 29,1999 <br />~ iii iiiiiiiiiiiu iii <br />iFCEIVED <br />JUN 2 5 1999 <br />.~sion of Minerals & Geology <br />~fl1/ <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Fremont <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an <br />operator shall subnut the atmual fee,-a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that aze anticipated [o occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach Vour revised annual report map and written report to this <br />annual report. please note that nn adequately labeled map that clenrly delineates and <br />includes the aGove elements mny suffice for a written repa~t. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name:,~JV~~/~ C }~VFG/~ <br />Address: /: ~i s~%OX ~3~ <br />~/~,~! ~v, CO <br />~/OCa2 ~es33 <br />Cotnpany:J(J/~~/% ~~/G/L ~)%G~~C7 <br />Phone No.: (7/r/) S~~ ~ ~aZ ~r~ <br />Fax No.: (7/ / ) ~~a~ -.So2 c{3 <br />If there are additional comments and/or inforn~ation that should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />~ ~ ,~~~ D~~t~- ~ z <br />Sin ur of Corporate Officer, o Owner Date <br />INSTRUCTIONS ON BACK <br />