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DII DID~I~~I~~~~~~I~ <br />sss <br />ANNUAL REPORT <br />PERMITTEE NAME: Coulson Excavating Company <br />PERMIT NO.: M-86-123 <br />OPERATION NAME: Kirtright Pit <br />ANNNERSARY DATE: November 07, 1999 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 <br />COUNTY: Latimer <br /> <br />0°~~ 0~~ <br />~~~~ErvE~ <br />t1Ci 12 1999 <br />• -~' ^+Minerals g Geolo9Y <br />According to C.R.S. 34-32-5-1-?b(-3j(a), each year, on-the anniversary-date of-the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during the upcoming year, reclamation [hat will be performed during the coming <br />year, the dates for the beginning of active operations, and the date active operations ceased for [he year, <br />if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />note thnt nn adequately labeled mnp !lint clearly delineates and includes the nbove elements nmy <br />since for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Con[ac[ Name: Richard Coulson, president Company: Coulson Excavating Company, Inc. <br />Adddress: 3609 North County Road 13 Phone No.: (970J 667-2178 <br />Loveland, Colorado 80538 Fax No.:( 9701 667-2193 <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />~~~~ October 7, 1999 <br />ignature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />