2005-01-14_REPORT - M1985026

• Permit No: M1985026
• IBM Index Class Name: Report
• Doc Date: 1/14/2005
• Doc Name: Annual Fee/Report/Map
• From: Coulson Excavationg Company Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~~l
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Coulson Excavating Company, Inc.
M-1985-026
Challenger Pit --- - _
January 31, 2005
$688.00 (Due on or before your anniversary date)
Weld
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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_report_and map showing-the_extent_of_current_disturbances to.affected land,
reclamafion accomplished to date and during the preceding yeaz, new disturbances that aze 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 yeaz, if any.
Please attach yonr revised written anneal report and anneal re~.pr.,rt main to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contaot: ~ Richard Coulson - - ' "'
Permittee Name: Coulson Excavating Company, Inc.
Address: 3609 N. CR 13
Loveland, CO 80538
Phone Number: [phone]
Fax Number: [phone]
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 of Corpora e Offic r, Owner, or Designee
Diana Moneypenny, Sec.
January 13, 2005
Date
Note: Mining has been canpleted at this pit site. Top soil has been placed in all areas
to be reclaimed. Seeding will be clone in these areas according to the reclamation
plan as soon as the gather permits in 2005.