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~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNPJERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Coulson Excavating Company, Inc. <br />M-1985-026 <br />Challenger Pit <br />January 31, 2006 <br />$688.00 (Due on or before your anniversary date) <br />Weld <br />JAS 15 2QQ6 <br />Di4181on ~f Minerals enEl$eglogy <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 permit, an operator <br />shall_submit_the_annual_fee,_a .repoct_and_map_showing.the..extent_of-can•ent_disturbances_to~affected_land,. <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 your revised written annual rennrt and annual report man to this fnrm_ please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Richard 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 [hat 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 />All areas mined have been reclaimed. Mining of this pit is canplete as planned, <br />top soil replacement is complete and all areas have been seeded. <br />1Z <br />Signature of Corporate ffice ,Owner, or Designee <br />Diana Moneypenny, Secretary <br />January 20, 2006 <br />Date <br />