2007-01-09_REPORT - M1977252 (2)

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b~~~ ~ ANNUAL FEE and REPORT REQUEST PERMITTEE NAME: / Robinson Brick Company PERMIT NO.: ~ M-1977-252 OPERATION NAME: Pioneer Mine ANNNERSARY DATE: January 13, 2007 ANNUAL FEE DUE: $$688.00 (Due op or before your anniversary date) COUNTY: Douglas Ol_ tD-o7 lVlli»liy LLCI o6u.j 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 shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, 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 vour revised written annual report and annual report map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated man. If no new disturbances or reclamation have occurred durinc the previous vear and no new chances to the previous year's map are necessary. then no new map is required, provided that the Ouerator shall state this in the Annual Report. 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 permittee contact information. Please verify and make any necessary changes: Permittee Contact: Marvin R. Myers, Jr. Permittee Name: Robinson Brick Company Address: 1845 W. Dartmouth Ave. Englewood, CO 80110 Phone Number: (303) 783-3046 Fax Number: (303)783-2992 If you have additional comments and/or information that should be provided to the Division, please provide below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. lr Signature of Corpor Offi ,Owner, or Designee ~3 ~ ~~~ Date T