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ANNUAL REPORT ®~' <br />PERMITTEE NAME: Western Mobile Boulder, Inc. ~~ .1, <br />PERMTI' NO.: M-74-015 ®~ <br />OPERATION NAME: Lyons Pit <br />ANNNERSARY DATE: September 09, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <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 />[o 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 tAot an adequately labeled map that clearly delineates nrtd <br />includes t{te above elements may since for n written report. <br />Please type or print the current contact person's name, mailing address, and phone member in the <br />space provided: <br />Contact Name: ~~i ~ ~~ Ka~~-~,~tZ Company: U1Q~~„n NtoS; ~t a S~bc;d,c.~~ ~ti~v <br />Address:~ /s9o ~~ ~ f / Z ~{Are Phone No.: ('30 3 ) / S} - `l 3 30 <br />.J~.,,, E, to /f'a~o `!~ Fax No.: (~03 ) 6 s} - y 3~9 <br />If there aze additional comments and/or information that should be provided to the Division, <br />please provide it on a sepazate sheet and attach it [o this report form along with your map and/or <br />written report. <br />9/ZZ /99 <br />Sig ture of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />