2015-07-01_REPORT - M1987088

• Permit No: M1987088
• IBM Index Class Name: REPORT
• Doc Date: 7/1/2015
• Doc Name: Annual Fee, Report and Map
• From: Hubbs III, LLC
• To: DRMS
• Email Name: LJW
• Media Type: D
• Archive: No

Page 5 of 5
Division records indicate the following permittee contact information. If this information is not current, please type or
print current contact information:
Permittee Contact:
BarbaraE. Hubbs
Permittee Company:
Hubbs III, LLC
Address:
367 CR 129
Hesperus, CO81326
Phone Number:
[phone]
-30
Fax Number:
Email Address:
[e-mail]
I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are
being conduc!4in accordance with the Division approved mining and reclamation plans.
Owner, or
M -AF -01
e-07,1- /'.7'
Date