2017-01-31_REPORT - M1977151

• Permit No: M1977151
• IBM Index Class Name: REPORT
• Doc Date: 1/31/2017
• Doc Name: Annual Fee/Report/Map
• From: R M Hiner Construction
• 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: Rex M.Hiner
Permittee Company: R M Hiner Construction Co Inc
Address: 11 Austin Rd
Lamar, CO 81052-4301
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail] [e-mail]
Permitting Contact: Rex M.Hiner
Company: R M Hiner Construction Co Inc
Address: 11 Austin Rd
Lamar, CO 81052
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail] [e-mail]
Inspection Contact: Rex M.Hiner
Company: R M Hiner Construction Co Inc
Address: 11 Austin Rd
Lamar, CO 81052
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail] [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 accordance with the Division approved mining and reclamation plans.
A
r
Jan. 27, 2017
Signature of Permittee, Corporate Officer,Owner,or Documented Designee Date
M-AF-01