2015-10-22_REPORT - M1997065

• Permit No: M1997065
• IBM Index Class Name: REPORT
• Doc Date: 10/22/2015
• From: Stone Wholesale Inc.
• To: DRMS
• Annual Report Year: 2015
• 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:
Jim Striggow
Permittee Company:
Stone Wholesale, Inc.
Address:
4717 Bay View Dr.
Fort Collins, CO 80526
Phone Number:
[phone]
Fax Number:
[phone]
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 conducted in accordancp-wi�h the Division approved mining and reclamation plans.
Signature of
M -AF -01
Owner, or Documented Designee
/z�-l%->S"'
Date