2003-06-24_REPORT - M1990112

• Permit No: M1990112
• IBM Index Class Name: Report
• Doc Date: 6/24/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
<~ NNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Western Mobile Southern, Inc.
M-1990-112
state Pit
June 15, 2003
$688.00 (Due on or before your anniversary date)
Pueblo
RECEIIlE[9
1UN 2 4 2003
Division ~f Minerals and Geology
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-I I6,'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 ynnr revised written annual rennrt and annual ~nrt m to this form- Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffrce for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Gary J. Tuttle
Pemuttee Name: Western Mobile Southem, 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 this form along with your written report and map. Annual Report instructions are enclosed.
Signature of Corporate Officer, Owner, or Designee
Date
M:~PERMINAASTERD000MENT54M-AF-01