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RECEIVED <br />ANNUAL FEE and REPORT REQUEST <br />JUL 0 3 2002 <br />Division of Minerals and Geology <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Western Mobile Southern, Inc. <br />M-1997-087 <br />Hartman Pit <br />June 15, 2002 <br />$688.00 (Due on or before your anniversary date) <br />Pueblo <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on [he anniversary date of the permit, an operator <br />shall_submit_the_annua]_fee, a_report_and .map showing the extenLOf_current_disturbances to_affected._]and, __ - <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />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 Heat clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Eric Reckentine <br />Permittee Name: Western Mobile Southern, Inc. <br />Address: 1590 W. 12th Ave. <br />Denver, CO 80204 <br />Phone Number: (303) 657-4330 <br />Fax Number: (303) 657-4339 <br />If you have additional comments and/or information that should be provided to the Division, please provide i[ <br />below or attach i[ [o [his form along with your written report and map. Annual Report instructions are enclosed. <br />.~ <br />Signature~of! orporate Officer or Owner <br />/L`r7 ~ <br />Date LLL~~~ <br />M:~PERMIT VNASTERDOCUMEMSNI-AF-01 <br />