2006-03-14_REPORT - M1996089

• Permit No: M1996089
• IBM Index Class Name: Report
• Doc Date: 3/14/2006
• Doc Name: Annual Fee/Report/Map
• From: Skoglund Excavating Inc.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
V ANNi1Ai. FF.F, and RF.Pt1RT RF.ni1F.ST
//Skoglund Excavating Inc.
M-1996-089
Skoglund Pit
March 20, 2006
RECEIVED
MAR 14 ?006
~ivision ~t Minerels end Geology
$688.00 (Due on or before your anniversary date)
Saguache
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.-subrnit-tlae-annual-fee-a-.report-and-map--showing-the extent-of-ourrent disturbances-to-aff~cted-9suZ1-'-'
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
-- during the upcoming year, reclamation thafwill lie performed during the coming year,-the dates for the`6eginning-
^F°~ ~i-v~o"perations,-and-the-date-active-operatjens-ceased-fer-the-year,-if-any-
Please attach ym.r revised written annnal report and anm.al repnrf m ~n to this form. Please note that 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: Kenneth L. Skoglund
Permittee Name: Skoglund Excavating Inc.
Address: 11th and Broadway
P.O. Box 209
Moffat, CO 81143
~ l+na ~ I - 1 n.~ olren`~l~l and . Coth „~
Phone Number: [phone]
-Eax_Number;.- - - ~719)~-56-4I34- - - -°- - -~~ ~~3 L 1t'' ~-(~-t~~--- ~- --
1f 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.
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Signa e o Corporate O ' cer, Ow r, or Designee
3 - 13 ~a(o VVV
Date