2016-11-17_REPORT - M2006078

• Permit No: M2006078
• IBM Index Class Name: REPORT
• Doc Date: 11/17/2016
• Doc Name: Returned Mail
• From: DRMS
• To: Flatiron Constructors
• Email Name: PSH
• Media Type: D
• Archive: No

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: Justin DuMond
Permittee Company: Flatiron Constructors, Inc.
Address: 10188 E. I25 Frontage Rd.
Firestone, CO 80504
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Permitting Contact: Mike Hart
Company: Hart Environmental
Address: P.O. Box 1303
Boulder, CO 80306
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Inspection Contact: Justin DuMond
Company: Flatiron Constructors, Inc.
Address: 10188 E. I25 Frontage Rd.
Firestone, CO 80504
Phone Number: [phone]
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.
Signature of Permittee, Corporate Officer,Owner,or Documented Designee Date
M-AF-01