REP34511

• Permit No: M1987131
• IBM Index Class Name: Report
• Doc Date: 5/21/2002
• Doc Name: 2002 Annual Report
• From: Western Mobile Southern Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMIT'TEE NAME:
PERMff NO.:
OPERATION NAME:
ANNPJERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Western Mobile Southern, Inc.
M-1987-131
Penrose Pit
June 15, 2002
$688.00 (Due on or before your anniversary date)
Fremont

RECENED
MAY y ~
Division at Minerals and Geology
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, areport-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 [he date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report maa 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: Eric Reckentine
Permittee Name: Western Mobile Southern, Inc.
Address: 1590 W. 12th Ave.
Denver, CO 80204
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Phone Number: (303) 657~338'~
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach i[ to this form along with your written report and map. Annual Report instructions are enclosed.
Signature of o orate Officer or Owner
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Date T° ~
M:W ERMITNIASTERDOCUMENTSVN-AF-OI