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,,, <br />~~ ~ ~P ~ <br />ANNUAL FEE and REPORT RE VEST/ ~ ~ ~ ~~ <br />PERMITTEE NAME: Coulson Excavating Company, Inc. / FEB 19 2008 <br />PERMIT NO.: M-2000-156 ~ ®iv,s,or~ c~; ~cv,;~unati0P1, <br />OPERATION NAME: Bonser Pit Mining and Safety <br />ANNIVERSARY DATE: March 5, 2008 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Larimer <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 report and map showing the extent of current disturbances to affected land, <br />__ _ ~_reclaration-acsemplished-to-date-and-daring-the-preceding-year-rrew-disturbances-that-are~rrti~cipated-to occar - -- <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 report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Re-port. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may su f ce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Ken Coulson <br />Permittee Name: Coulson Excavating Company, Inc. <br />Address: 31509 North County Road 13 <br />Loveland, CO 80538 <br />Phone Number: (970) 667-2178 <br />Fax Number: (x)70) 667-2193 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />be w or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />~***Mining at the Bonser Pit has not started as of this date <br />Signature of Corporate; fficer, caner, or Designee <br />Diana Moneypenriy, Co Sec. <br />Feb. 18, 2008 <br />Date <br />