2017-02-16_REPORT - M1993050

• Permit No: M1993050
• IBM Index Class Name: REPORT
• Doc Date: 2/16/2017
• Doc Name: Annual Fee/Report/Map
• From: Raymond & Robert Dellacroce
• 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: Julie Sevier
Permittee Company: Raymond F. &Robert W.
Dellacroce
Address: Pioneer Sand Co.,Inc. �l -�h ,rk Y k LY
Colwd o -'yo'K 23; co �o9/9
Phone Number: [phone] 4
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: Ron Turner
Company: Resource Geoscience, Inc.
Address: 19 East Willamette Avenue
Colorado Springs, CO 80903
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Inspection Contact: Raymond F.Dellacroce
Company: Raymond F. &Robert W.
Dellacroce
Address: 2210 West Baptist Road
Colorado Springs, CO 80921
Phone Number: [phone]
Fax Number: [phone]
Email Address:
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 Division approved mining and reclamation plans.
nature of Aerinittee.Corporate Officer,Owner,or Documented Designee Date
-AF-01