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~ . • iii iiiiiiiiiiiii iii <br />110 Enclosure <br />Permittee Name: Summit Brick & Tile <br />Permit No: Id_77_321 FEB 291988 <br />Operation Name: Native/pierre Mine <br />Anniversary Date: 02/17/88 MINED LAND <br />CiECLp,MATION DIVISION <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />X Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due $~c3-° <br />X Annual Report (See Below) <br />Remarks: <br />A). Land affected during 10th year - 0 acres. <br />B). land anticipated to be disturbed during the next year is 1/8 to 1/4 acre. <br />C). No land was reclaimed during the_last year. <br />5lgnature osE/ph C. welte <br />(Rev. 02 7) <br />5257E <br />~1`y `~ <br />