2016-07-22_REPORT - M1983193

• Permit No: M1983193
• IBM Index Class Name: Report
• Doc Date: 7/22/2016
• Doc Name: Annual Fee/Report/Map
• From: R E Monks Construction Co.
• 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:
Leroy Garcia
Permittee Company:
R E Monks Construction Co.
Address:
P.O. Box 25579
Colorado Springs, CO 80936
Phone Number:
[phone]
Fax Number:
[phone]
Email Address:
[e-mail]
1, 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.
turdof
h1 -AF -01
Owner, or Documented Designee Date