2017-02-09_REPORT - M1987178

• Permit No: M1987178
• IBM Index Class Name: REPORT
• Doc Date: 2/9/2017
• Doc Name: Annual Fee/Report/Map
• From: Parkerson Construction, Inc.
• To: DRMS
• Annual Report Year: 2017
• Email Name: SJM
• 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: Alan Parkerson
Permittee Company: Parkerson Construction, Inc.
Address: 710 S. 15th St
Grand Junction, CO 81501
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: Alan Parkerson
Company: Parkerson Construction, Inc.
Address: 710 S. 15th St
Grand Junction, CO 81501
Phone Number: [phone]
Fax Number:
Email Address: [e-mail]
Inspection Contact: Alan Parkerson
Company: Parkerson Construction, Inc.
Address: 710 S. 15th St
Grand Junction, CO 81501
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 accordan ith the Division approved mining and reclamation plans.
2-6-�'7
Si nature of Permit We, Corporate Officer,Owner,or Documented Designee Date
NI-AF-01