2017-02-21_M2013081_Annual Fee Notice ARCHIVE

• Permit No: M2013081A
• IBM Index Class Name: Report
• Doc Date: 2/21/2017
• Doc Name: Annual Fee Notice
• From: DRMS
• To: Tomichi Materials, LLC
• Annual Report Year: 2017
• Media Type: D
• Archive: Yes

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:

Byron R. Chrisman
Permittee Company:

Tomichi Materials, LLC
Address:

864 W. Boulder Road,Suite 200
Louisville, CO 80027

Phone Number:

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

Byron R. Chrisman
Company:

Tomichi Materials, LLC
Address:

864 W. South Boulder Road
Louisville, CO 80027

Phone Number:

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

Byron R. Chrisman
Company:

Tomichi Materials, LLC
Address:

864 W. South Boulder Road
Louisville, CO 80027

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-04