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• iii iiiiiiiiiiiu iii <br />ANNUAL REPORT <br />PERMITTEE NAME: Western Mobile Northern Inc <br />PERMIT NO.: M-81-088 <br />OPERATION NAME: McCoy Aggregates <br />ANNNERSARY DATE: December 10,1999 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 <br />COUNTY: Routt <br />~ ~~~ <br />RECEIVED <br />MAR 0 2 2000 <br />Division of Minerals & Geology <br />According to C.R.S. 34-32.5-I 16(3)(a), 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 <br />land, reclamation accomplished to date and during the preceding year, new disturbances that ate <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, [he dates for the beginning of active operations, and the date active operations ceased for the year, <br />if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />note that an adequately labeled map that clearly delineates and inchules the above elements nary <br />suffice for a wriiteri report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: >plc. REC.kc-Nnnte <br />Adddress: 15~o W ~ lZr"` AvF. <br />Dc-t,tv~~ co ~o2og <br />Company: I.fFFAy [~E <br />Phone No.: (30~ 1~5~-- 93 is <br />Fax No.: ('St=3) m57--43~s~ <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />~/3/~ <br />Signature f Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />