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:~~ <br />• ~ <br />ANNUAL REPORT <br />PERMITTEE NAME: Summit Brick & Tile Co. <br />PERMTI' NO.: M-1977-321 RECEIVED <br />OPERATION NAME: Native/Pierre Mine FEB 18 2000 <br />ANNNERSARY DATE: February 17, 2000 Division of Minerals ~ Geology <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $225.00 <br />COUNTY: Pueblo <br />mmiiinmii~u <br />~~0~~ <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an operator shall <br />submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that aze anticipated <br />to occur during the upcoming year, reclamation that will be performed during the coming yeaz, the <br />dates for the beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this annual report. Plense <br />note that an ndeyuntely labeled Wrap that clenrly delinentes and includes die above elements may <br />suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name:~OSEf~ff e y(/F~rF <br />Address: ~, O, ~OX S 33 <br />/wLi!'~ LO , Ga <br />~~a -~s.~ <br />Company: SyMiN/T i~iQ/L~~ L jLG ~O <br />FAX No.: (~~~) Stfa2 -S~ t{3 <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />C a / 7 2ovo <br />Signat r of rporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />M1t:~PERA7 mM ASTER DOCU MENTSN7-AF-OI <br />