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~/- ~ ATE OF CO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources ANNUAL FEE and REPORT REQUEST <br />1313 Sherman St., Room 215 ~ <br />Denv}113IaIvIldoIt~IDNAME; 'Coulson Excavating Company, Inc. ~~~. D O L Oi o N o~ <br />Phone: (303} 866-3567 RECLAMATION <br />FAx:$b'~A43"~1DHJ.: ~M-2002-078 ~~~~~~ MI &NG <br />OPERATION NAME: Stroh Pit t~~B QSZ ' SAFETY <br />~tvr: O <br />ANNIVERSARY DATE: February 1, 2007 ~7i' 9 ~S oary n colveDrnor s <br />ANNUAL FEE DUE: $$688.00 (Due on or before your anniversary date)ty <br />Russell George <br />COUNTY: Larimer Executive Director <br />Ronald W. Cattany <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the pG~f'tlfr"~'t rator <br />shall submit the annual fee, a report and map showing the extent of current disturbances ~o` aff&ec~er rlari~ <br />reclamation accomplished to date and during_the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components; fee, report, and associated <br />maa. If no new disturbances or reclamation have occurred during the previous vear and no new chances to <br />the previous year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Resort. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Pelmittee Contact: Ken Coulson <br />Permittee Name: Coulson Excavating Company, Inc. <br />Address: 3609 N CR 13 <br />Loveland, CO 80538 <br />Phone Number: (970) 667-2178 <br />Fax Number: (970) 667-2193 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />No mining has begun at the Stroh Pit. Final Larimer County permitting is still in <br />process. <br />Signature of Corporate O icer, weer, or Designee <br />Diana Moneypenny, Secretary <br />January 31, 2007 <br />Date <br />Office of Office of <br />Mined Land Reclamation Active and Inattive Mines <br />