REP51435

• Permit No: M1974015
• IBM Index Class Name: Report
• Doc Date: 3/5/2002
• Doc Name: 2002 Annual Report
• From: Western Mobile Boulder Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

1 l~
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Western Mobile Boulder, Inc.
M-1974-015
Lyons Pit
February 15, 2002
RECEIVED
MAR 0 5 2002
Division of Minerals and Geology
$688.00 (Due on or before your anniversary date)
Boulder
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, 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 aze anticipated to occur
during the upcoming yeaz, 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 nn
adequately labeled map that clearly delineates and inckides the above elements mcry suffice far a written report.
Division records indicate the following pertnittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Eric Reckentine
Permittee.Name: Wes[em Mobile Boulder, Inc.
Address: 1590 W. 12th'AVe.
Denver, CO 80200
Phone Ntimber: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide i[
below or attach i[ to this form along with your written report and map. Annual Report instructions are enclosed.
~~_
Signature o~f Corporate Officer or Owner
// ~~~ 1
Date ~
hL~PERM lTN1ASTER DOCUMENTSU4-AF-O7