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~ :. ~ <br />ANNUAL REPORT <br />PERMITTEE NAME: Western Mobile Southern, Inc. <br />PERMIT NO.: M-1990-112 <br />OPERATION NAME: State Pit <br />ANNNERSARY DATE: January 7, 2000 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 <br />COUNTY: Pueblo <br />1'x011 <br />RECEIVED <br />JAN 31 2000 <br />Division of Minerals ~ Geo1o9Y <br />According to C.R.S. 34-32-116(3)(x), each year, on the anniversary date of the permit, an operator shall <br />submit the annual fee, a repoit and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that aze anticipated <br />to occur during the upcoming year, reclamation that will be performed during the coming year, the <br />dates for the beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your. revised annual report map and written report to this annual report. Please <br />note that nn adequately labeled map thnt clearly delineates and includes the above elements may <br />since for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: Gy' ~ ~ e-c Ko+,~-i^e Company: e <br />Address: l ~ b w ~ ~-+-~- ~-c. Phone No.: ~ o <br />on.,,.~- C d ~o Lo `-/ FAX No.: (~d~ l bS~-- - x{33 9 <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />Signature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />o>>~'/GYJ <br />M ~PERMFIV.1ASTERD000MEM'SU1-AF-01 <br />