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l 999 �// v <br /> ANNUAL REPORT / <br /> PERMITTEE NAME: Western Mobile Boulder, Inc. <br /> PERMIT NO.: M-81-302 RECE��E p <br /> OPERATION NAME: Deepe Farm Pit MAY <br /> 7 1999 <br /> ANNIVERSARY DATE: June 23, 1999 Divis(pnolMin <br /> ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 etay8 geology <br /> COUNTY: Boulder <br /> According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an <br /> operator shall submit the annual fee, a report and-map showing the extent of current disturbances <br /> to affected land, reclamation accomplished to date and during the preceding year, new <br /> disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br /> performed during the coming year, the dates for the beginning of active operations, and the date <br /> active operations ceased for the year, if any. <br /> Please attach your revised annual report map and written report to this <br /> annual report. Please note that an adequately labeled map that clearly delineates and <br /> includes the above elements may suffice for a written report. <br /> Please type or print the current contact person's name, mailing address, and phone number in the <br /> space provided: <br /> Contact Name: Company: We��erno� fe_ (Lnrev9t) <br /> Address: S"90 W ,ram r4 Aile Phone No.: ( 303 , bf}-y33o <br /> Fax No.: ( 303 ) 6-1­1 - q3 U <br /> If there are additional comments and/or information that should be provided to the Division, <br /> please provide it on a separate sheet and attach it to this report form along with your map and/or <br /> written report. <br /> -12-�247� <br /> /9 <br /> Signature of Corporate Of icer, or Owner Date <br /> INSTRUCTIONS ON BACK <br />