REP49109

• Permit No: M1988042
• IBM Index Class Name: Report
• Doc Date: 3/4/2002
• Doc Name: 2002 Annual Report
• From: Western Mobile Boulder Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

I ^
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Western Mobile Boulder, Inc.
M-1988-042
Cottonwood Pit
February 15,2002
RECEIVE®
MAR 0 41002
DiViSion of Minerals and Geology
$688.00 (Due on or before your anniversary date)
Weld
According [o 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, a report 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 the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map 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 Boulder, Inc.
Address: 1590 W. 12th Ave.
Denver, CO 80204
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to [his form along with your written report and map. Annual Report instructions are enclosed.
Signature of Corporate Officer or Owner
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