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• III IIIIIIIIIIIII III <br />sss <br />ANNUAL REPORT <br />PERMITTEE NAME: Western Mobile Southern, Inc. <br />PERMIT NO.: M-1986-159 <br />OPERATION NAME: Cortner Pit <br />ANNNERSARY DATE: February 6, 2000 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 <br />COUNTY: Pueblo <br />~,FCEIVE <br />~ •' 1 2~~ <br />J. ~ - <br />of MrneraM & ~ettlOgY <br />a°a I IG <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permi , an operator shall <br />submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances th t are anticipated <br />to occur during the upcoming year, reclamation that will be performed during the co ing year, the <br />dates for the beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach our revised annual re ort ma and written re ort to this annual a ort. Please <br />note tkat nn adequately labeled map that clearly delineates and includes the above a meats may <br />suffice for a written 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: ~r c e </cr„a~.a-P <br />Address: ~S~o L/ /~k /iir <br />Company: < <br />Phone No.: ~-r' ~o <br />FAX No.: ~0 3 dry - ~.~ <br />If there are additional comments and/or information that should be provided to the Di{~ision, please <br />provide it on a separate sheet and attach it to this report form along with your map an or written <br />report. <br />l~a~/Da i <br />Signature of orporate Officer, or Owner Dale <br />INSTRUCTIONS ON BACK <br />M:~PERMI f Vd ASTERDOCUMENTSN1-AF-01 <br />