2017-01-11_REPORT - M1973007SG

• Permit No: M1973007SG
• IBM Index Class Name: REPORT
• Doc Date: 1/11/2017
• Doc Name: Annual Fee/Report/Map
• From: Continental Materials Corp
• To: DRMS
• Annual Report Year: 2017
• Email Name: TC1
• 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: Andre Laroche
Permittee Company: Continental Materials
Corporation
Address: 444 E. Costilla St.
Colorado Springs, CO 80903
Phone Number: �0
719 475-0700 x2048
Fax Number: [phone]
Email Address: Andre—[e-mail]
Permitting Contact: Mffk Heifiter
Andre Laroche
Company:
Seriees Transit Mix Concrete Co.
Address: 37 E. Gale-ade A-'e
tom,._-.__ nn 89219 3 i 95
444 East Costilla Street
Colorado Springs, CO 80903
Phone Number: (303)?^a 9067
[phone] x2048
Fax Number: ^7" 37
719 475-0226
Email Address: [e-mail]
Inspection Contact:
Andre Laroche
Company: -r_____t mix^--met
Transit Mix Concrete Co.
Address: 444 East Costilla Street
Colorado Springs, CO 80903
Phone Number: p ^`227 29.ts
[phone] x2048
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 ac ordance with the D' isio - pproved mining and reclamation plans.
01-04-2017
Signature of Permittee, Corporate Officer,Owner,or Documented Designee Date