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~ iii iiiiiiiiiiiii iii <br />ANNUAL REPORT <br />PERMITTEE NAME: Coulson Excavating Company <br />PERMIT NO.: M-79-059 <br />OPERATION NAME: Brownwood Pit <br />ANNNERSARY DATE: November 20, 1999 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 <br />COUNTY: Larimer <br /> <br />~~~~ooo <br />~~G~~~~O <br />121999 <br />QG c,~\~ta~h~eow+~Y <br />U`~~g~On <br />According to C.R.S. 34-32.5-1 l6(3xa),.each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginning of active operations, and [he date active operations ceased For the year, <br />if any. <br />Please attach Your revised annual report map and written report to this annual report. Please <br />note thnt mt adequately lnbeled map that clearly delineates and includes the above elements may <br />suffice for a written report. <br />Please type or print [he current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: Richard Coulson, president Company: Coulson Excavating Company, Inc. <br />Adddress: X609 Nnrrh Cnnnt~ Rnarl t't Phone No.: (9701 667-2178 <br />Loveland, Colorado 80538 Fax No.:(97q 667-2193 <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 />u ~e'o October 7. 1999 <br />tgnature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACX <br />