2016-11-28_REPORT - M2014027

• Permit No: M2014027
• IBM Index Class Name: REPORT
• Doc Date: 11/28/2016
• Doc Name: Annual Fee/Report/Map
• From: Colorado Mining and Exploration, LLC
• To: DRMS
• Annual Report Year: 2016
• Email Name: SJM
• 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: Jake Wilkinson
Permittee Company: Colorado Mining and 'l
Exploration, LLC
Address: 502 S. Wisconsin Ave.
Gunnison, CO 81230
Phone Number: [phone]
77 /lam �J h�
Fax Number:
Email Address: [e-mail] �? vv I v M
Permitting Contact: Bob Gydesen
Company: Colorado Mining and
Exploration, LLC
Address: 502 S. Wisconsin Ave..
Gunnison, CO 81230
Phone Number: [phone]
Fax Number:
Email Address:
Inspection Contact: Bob Gydesen
Company: Colorado Mining and
Exploration,LLC
Address: 502 S. Wisconsin Ave.
Gunnison, CO 81230
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.
2
Signature of Permitte Cor orate Officer,Owner,or Documented Desiznee Dale
M-AF-02