2015-07-20_REPORT - M1994118

• Permit No: M1994118
• IBM Index Class Name: REPORT
• Doc Date: 7/20/2015
• Doc Name: Annual Fee, Report and Map
• From: Fremont County
• To: DRMS
• Email Name: TC1
• Media Type: D
• Archive: No

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Division records indicate the following permittee contact information. If this information is not current, please type or
print current contact information:
Permittee Contact:
Sterling Rife
Permittee Company:
Fremont County
Address:
1170 Red Canyon Road
Canon City, CO 81212
Phone Number:
[phone]
Fax Number:
[phone]
Email Address:
I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are
being conducted in accordance with the Division approved mining and reclamation plans.
M -AF -04
ture of armidee, Corporate Officer, Owner, or Documented Designee Date