2016-12-16_M1993050_Annual Fee Notice ARCHIVE

• Permit No: M1993050A
• IBM Index Class Name: Report
• Doc Date: 12/16/2016
• Doc Name: Annual Fee Notice
• From: DRMS
• To: Raymond F. & Robert W. Dellacroce
• Annual Report Year: 2017
• 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:

Julie Sevier
Permittee Company:

Raymond F. & Robert W.
Dellacroce

Address:

Pioneer Sand Co., Inc.
P.O. Box 7650
Colorado Springs, CO 80903

Phone Number:

[phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact:

Ron Turner
Company:

Resource Geoscience, Inc.
Address:

19 East Willamette Avenue
Colorado Springs, CO 80903

Phone Number:

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

Raymond F. Dellacroce
Company:

Raymond F. & Robert W.
Dellacroce

Address:

2210 West Baptist Road
Colorado Springs, CO 80921

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