REP15253

• Permit No: M2000041
• IBM Index Class Name: Report
• Doc Date: 6/21/2002
• Doc Name: 2002 Annual Report
• From: Western Mobile Southern Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RE~~~~E®
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Western Mobile Southern, Inc.
M-2000-041
Evans Pit #2
June 21, 2002
JUN 1° / 2002
Division of Minerals and ~aolo9Y
$688.00 (Due on or before your anniversary date)
Pueblo
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, 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 vour revised written annual reuort and annual report man to this form. 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: Gary Tuttle
Permittee Name: Westem Mobile Southern, Inc.
Address: 1590 W. 12th Ave.
Denver, CO 80204
LA-FfI-rGt c~T, ~1(~ .
Phone Number:
Fax Number:
[phone]'
[phone]
~33a
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.
~t .~~ ~..
Signature of Corporate Officer or Owner
~~9~~ L
Date
M:~PERM771MASTERD000MEMSNI-AF-O7