2015-08-05_REPORT - M1977546

• Permit No: M1977546
• IBM Index Class Name: REPORT
• Doc Date: 8/5/2015
• From: Brice & Phyllis Lee
• To: DRMS
• Annual Report Year: 2015
• Email Name: LJW
• Media Type: D
• Archive: No

Ci
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:
BriceF. Lee
Permittee Company:
Brice F Lee & Phyllis J Lee
Address:
940 CR 119
Hesperus, C081326
Phone Number:
[phone]
Fax Number:
[phone]
Email Address:
,fJ�) ®®.1� (\//-,'�/��/'� .
C-� �C.dCJV , e
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 -01
of irmittee, Corporate Officer, Owner,�r Documented Designee
Date