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IIIIlllllllllN11, <br /> ^ti ANNUAL I 999 QUEST RECEIVED <br /> PERMITTEE NAME: Skoglund Excavating Inc. K'..l 2 0 2001 <br /> PERMIT NO.: M-1996-089 <br /> Division of Minerals and Geology <br /> OPERATION NAME: Skoglund Pit <br /> ANNIVERSARY DATE: March 20,2001 <br /> ANNUAL FEE DUE: $688.00(Due on or before your anniversary date) <br /> COUNTY: Saguache <br /> According to C.R.S. 34-32.5-I16 or C.R.S. 34-32-116, each year, on the anniversary dale of the permit, an <br /> operator 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 anticipated to <br /> occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br /> beginning 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. Please note that an <br /> adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Kenneth L. Skoglund <br /> Perm ittee Name: Skoglund Excavating Inc. <br /> Address: 1 I th and Broadway <br /> P.O. Box 209 <br /> Moffat, CO 81143 <br /> Phone Number: (719)256-1447 <br /> Fax Number: (719)256-4154 <br /> If you have additional comments and/or information that should be provided to the Division, please provide it <br /> below or attach it to this form along with your written report and map. Annual Report instructions are <br /> enclosed. <br /> p --, ,Q <br /> Signature of Corporate Officer or Owner <br /> �� — �—_ <br /> Date <br /> M TER UTIMASTERDOCUM&NTS M-Ar-01 <br /> 1 <br />