2001-05-22_REPORT - M1986159

• Permit No: M1986159
• IBM Index Class Name: Report
• Doc Date: 5/22/2001
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST
PERMITTEENAME: Western Mobile Southern, Inc. RECE�VED
PERMIT NO.: M-1986-159
OPERATION NAME: Cortner Pit MAY 2 2001
ANNIVERSARY DATE: June 15,2001 Division of Minerals and Geology
ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date)
COUNTY: Pueblo
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary da of the permit, an
e r, the d
operator shall submit the annual fee, a report and map showing the extent of current dist raaces to affected
b
land, reclamation accomplished to date and during the preceding year, new disturbances th t are anticipated to
occur during the upcoming year, reclamation that will be performed during the coming ye for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may s rice for a written
report.
Division records indicate the following permittee contact information. Please verify and rake any necessary
changes:
Permittee Contact: Eric Reckentinc
Permittee Name: Western Mobile Southern, Inc.
Address: 1590 W. 12th Ave.
I
Denver, CO 80204
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Divisio , please provide it
below or attach it to this form along with your written report and map. Annual Rep rt instructions are
enclosed.
Signature of Corporate Officer or Owner
Date
M:V ERM ITVUAASTERDOCUMENTS�M-AF-01