2015-09-15_REPORT - M2004030

• Permit No: M2004030
• IBM Index Class Name: REPORT
• Doc Date: 9/15/2015
• Doc Name: Annual Fee, Report & Map
• From: T Bone Stone, Inc
• To: DRMS
• Email Name: MAC
• 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:
BillTenore
Permittee Company:
T Bone Stone, Inc.
Address:
2337 Emery St
Longmont, CO80501
Phone Number:
[phone]
Fax Number:
[phone]
Email Address:
[e-mail]
I, the undersigned, hereby state that the
being conducte cc9 ance with !be
-d in this report is true and accurate, and that site operations are
mining and reclamation plans.
or Documented Designee
Date