2006-01-03_REPORT - M2000103

• Permit No: M2000103
• IBM Index Class Name: Report
• Doc Date: 1/3/2006
• Doc Name: Annual Fee/Report/Map
• From: Allen P. Small Trucking & Excavation Inc.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECElVEI~
JAN 0 3 2006
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME;
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Allen P. Small Trucking & Excavation, Inc.
M-2000-103
A.P.S. Trucking and Excavating, Inc.
January 23, 2006
$281.00 (Due on or before your anniversary date)
La Plata
Division of Minerals and Oe0ltlgy
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-er+reual-fee,-a-report-and_map-showing the_extent-of_current_disturbances~o_affected_land,
reclamation accomplished to date and during the preceding year, new disturbances that are 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 year, if any.
Please attach your revised written annnal renort and annnal report m~ 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:
Pennittee Contact: Allen P. Small
Permittee Name: Allen P. Small Trucking & Excavation,
Address: 13577 CR 213 - LA Posta Rd.
Durango, CO 81301
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 Corporate Officer, Owner, or Designee

Date