2016-10-14_M2010055_Annual Fee Notice ARCHIVE

• Permit No: M2010055A
• IBM Index Class Name: Report
• Doc Date: 10/14/2016
• Doc Name: Annual Fee Notice
• From: DRMS
• To: Konig Ag Co.
• Annual Report Year: 2016
• Media Type: D
• Archive: Yes

Page 5 of 5

Division records indicate the following permittee/landowner contact information (blank fields indicate that we do not have
information on record). If this information is blank or not current , please type or print current contact information:

Permittee Contact:

Joel Konig
Permittee Company:

Konig Ag Co.
Address:

37231 Hwy. 14
Briggsdale, CO 80611

Phone Number:

[phone]
Fax Number:
Email Address:
Permitting Contact:

Chris Rundall
Company:

Baseline Engineering Corp.
Address:

1536 Cole Blvd., Suite 220
Golden, CO 80401

Phone Number:

[phone]
Fax Number: [phone]
Email Address:
Inspection Contact:

Joel Konig
Company:

Konig Ag Co.
Address:

37231 Hwy. 14
Briggsdale, CO 80611

Phone Number:

[phone]
Fax Number:
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.

Signature of Permittee, Corporate Officer, Owner, or Documented Designee Date
M-AF-01