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2015-08-03_REPORT - M1978014
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2015-08-03_REPORT - M1978014
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Last modified
8/24/2016 6:09:36 PM
Creation date
8/4/2015 4:44:52 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1978014
IBM Index Class Name
REPORT
Doc Date
8/3/2015
Doc Name
Annual Fee, Report & Map
From
North Chieftain
To
DRMS
Email Name
MAC
Media Type
D
Archive
No
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Page 5 of 5 <br />Division records indicate the following permittee contact information. If this information is not current, please type or <br />print current contact information: <br />Permittee Contact: <br />Tony Fabrizio <br />Permittee Company: <br />General Shale Brick, Inc. <br />Address: <br />1845 W. Dartmouth Ave. <br />Denver, CO 80110-1308 <br />Phone Number: <br />(303) 783-3041 <br />Fax Number: <br />(303) 783-2992 <br />Email Address: <br />1, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are <br />being conducted in accorfilmNe with the Division approved mining and reclamation plans. <br />of Permittee, Nrpot ate Officer, Owner, or Documented Designee <br />M -AF -01 <br />Date <br />
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