2005-06-01_REPORT - M1986104

• Permit No: M1986104
• IBM Index Class Name: Report
• Doc Date: 6/1/2005
• Doc Name: Annual Fee/Report/Map
• From: Oldcastle SW Group Inc. dba B & B Excavation
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

uur~ o i 2005
/V
Odti~ion of N'i. erels & tlooloAY
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Oldcastle SW Group, Inc, d.b.a. B & B Excavating
M-1986-104
Montgomery Pit
May 24, 2005
$688.00 (Due on or before your anniversary date)
Eagle
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
shall submit the annual fee, a_repor[ and map showing the extent of current. disturbances. to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written anmial report and annnal rennrt m~ to Chic form- Please note [hat an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Jason Burkey
Permittee Name: Oldcastle SW Group, Inc. d.b.a. B & B Excavating
Address: P.O. Box 1729
Edwards, CO 81632
Phone Number: [phone]
Fax Number:
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
~~~~`
Signature o Corporate Officer, Owner, or Designee
S/23~i~~
Date
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