2017-04-14_REPORT - M2013054

• Permit No: M2013054
• IBM Index Class Name: REPORT
• Doc Date: 4/14/2017
• Doc Name: Annual Fee/Report/Map
• From: Boyce Land & Cattle
• To: DRMS
• Annual Report Year: 2017
• Email Name: SJM
• Media Type: D
• Archive: No

Page 5 of 5
Division records indicate the following permittee/landowner contact information(blank fields indicate that we do not have
information on record). If this information is blank or not current,please type or print current contact information:
Permittee Contact: Ken Skoglund
Permittee Company: Boyce Land&Cattle Co.,LLC s�(p���,� eYC.-V'1 Ti.t ja Inc.
Address: P.O. Box 209
Moffat,CO 81143
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: Ken Skoglund
Company: Skoglund Excavating Inc.
Address: 1075 Broadway Ave.
P.O.Box 209
Moffat,CO 81143
Phone Number: [phone]
Fax Number:
Email Address:
Inspection Contact: Ken Skoglund
Company: Skoglund Excavating Inc
Address: 1075 Broadway Ave.
P.O. Box 209
Moffat,CO 81143
Phone Number: [phone]
Fax Number:
Email Address:
1,the undersigned,hereby state that the information provided in this report is true and accurate, and that site operations are
being conducted in accordance with the Division approved mining and reclamation plans.
ab, �;� v L _ J
tee Signature of Permit ,Coruora a Officer,Ow ,or Documented Designee Date /
M-AF-01
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