2017-01-18_REPORT - M1980027

• Permit No: M1980027
• IBM Index Class Name: REPORT
• Doc Date: 1/18/2017
• Doc Name: Annual Fee/Report/Map
• From: Grand Gravel Pit, LLC
• To: DRMS
• Annual Report Year: 2017
• 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: Skylar Carpenter
Permittee Company: Grand Gravel Pit,LLC
Address: 2 County Road 2
Kremmling, Co 80459
Phone Number: [phone]
Fax Number:
Email Address: [e-mail]
Permitting Contact: Skylar Carpenter
Company: Grand Gravel Pit,LLC
Address: 2 County Road 2
Kremmling,CO 80459
Phone Number: [phone]
Fax Number:
Email Address: [e-mail]
Inspection Contact: Skylar Carpenter
Company: Grand Gravel Pit,LLC
Address: 2 County Road 2
Kremmling, CO 80459
Phone Number: [phone]
Fax Number:
Email Address: [e-mail]
I,the undersigned,hereby state that the information provided in this report is true and accurate,and that site operations are
being conducted in accorda ce with the Division approved mining and reclamation plans.
Signature o Permittee,Corporate Officer,Owner,or Documented Designee Date
M-AF-01