2008-12-22_REPORT - M1985026

• Permit No: M1985026
• IBM Index Class Name: REPORT
• Doc Date: 12/22/2008
• Doc Name: Annual Fee/Report/Map
• From: Coulson Excavating Company, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Email Name: MAC
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE a QUEST
Pcoulson Excavating Company, Inc.
"M-1985-026
Challenger Pit
January 31, 2009
RECEIVED
DEC 2 2 2008
ivision of R-damation,
-0 Mining and GO*
$$791.00 (Due on or before your anniversary date)
Weld
op-
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,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
- --- -- ----- ----- - ----- ---- -----
during the upcoming year, rec mdfion 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 vour revised written annual report and annual report map to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
map. If no new disturbances or reclamation have occurred during the previous year and no new changes to
the previous year's map are necessary, then no new map is required, provided that the Operator shall state
this in the Annual Report. 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: Richard Coulson
Permittee Name: Coulson Excavating Company, Inc.
Address: 3609 North County Road 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 Corp-orate fficer,Vwner, or Desigdee= - - -
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Date