2017-01-24_REPORT - M1998091

• Permit No: M1998091
• IBM Index Class Name: Report
• Doc Date: 1/24/2017
• Doc Name: Annual Fee/Report/Map
• From: Joseph L and Arlene Cogan DBA B.B.L. COGAN, L.L.C.
• To: DRMS
• Annual Report Year: 2017
• Email Name: DMC
• 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: Joseph L.Cogan
Permittee Company: Joseph L and Arlene Cogan
DBA B.B.L. COGAN,L.L.C.
Address: P.O. Box 113
Nathrop, CO 81236
Phone Number: [phone]
Fax Number:
Email Address:
Permitting Contact: Joseph L.Cogan
Company: Joseph L.and Arlene Cogan
Address: 24899 U.S. Highway 285
P.O. Box 113
Nathrop, CO 81236
Phone Number: [phone]
Fax Number: kA�,(X
Email Address: I`�
0
Inspection Contact: Jos ph L.Cogan
Company: Joseph L.and Arlene Cogan
Address: 24899 U.S. Highway 285
P.O. Box 113
Nathrop, CO 81236
Phone Number: [phone]
Fax Number: XV
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 ccordance with the Division approved mining and reclamation plans. /
I a5V-1--V I/ I
Signature of erl6ittee,Coro to Officer.Owner,or Documented Designee Dat
M-AF-01