2017-02-21_REPORT - M2008078

• Permit No: M2008078
• IBM Index Class Name: Report
• Doc Date: 2/21/2017
• Doc Name: Annual Fee Notice
• From: DRMS
• To: Prowers Aggregate Operators, LLC
• Annual Report Year: 2017
• 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:

Karl Nyquist
Permittee Company:

Prowers Aggregate Operators,
LLC

Address:

7991 Shaffer Parkway, Suite 200
Littleton, CO 80127

Phone Number:

[phone]
Fax Number:
Email Address: [e-mail]
Permitting Contact:

Karl Nyquist
Company:

Prowers Aggregate Operators,
LLC

Address:

7991 Shaffer Parkway, Suite 200
Littleton, CO 80127

Phone Number:

[phone]
Fax Number:
Email Address: [e-mail]
Inspection Contact:

Karl Nyquist
Company:

Prowers Aggregate Operators,
LLC

Address:

7991 Shaffer Parkway, Suite 200
Littleton, CO 80127

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 accordance with the Division approved mining and reclamation plans.

Signature of Permittee, Corporate Officer, Owner, or Documented Designee Date
M-AF-01