2016-06-21_REPORT - M1977211

• Permit No: M1977211
• IBM Index Class Name: Report
• Doc Date: 6/21/2016
• Doc Name: Annual Fee/Report/Map
• From: Pikeview Quarry
• To: DRMS
• Annual Report Year: 2016
• Email Name: TC1
• 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:
Andre Laroche e-mail: andre [e-mail]
Permittee Company: Continental Materials
Corporation
Address: 444 E.Costilla St.
Colorado Springs,CO 80903
Phone Number: [phone] office
[phone] cell
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.
'IM C06-20-2016
Signature of P ittee Cor orateI�Z& cer,Ower or D 7nted Designee n , Documented Date
M•Ar-01