2017-02-21_M1978283_Annual Fee Notice ARCHIVE

• Permit No: M1978283A
• IBM Index Class Name: Report
• Doc Date: 2/21/2017
• Doc Name: Annual Fee Notice
• From: DRMS
• To: Walsenburg Sand & Gravel Co., Inc.
• 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:

Louis Vezzani
Permittee Company:

Walsenburg Sand & Gravel Co.,
Inc.

Address:

P.O. Drawer 352
Walsenburg, CO 81089

Phone Number:

[phone]
Fax Number: [phone]
Email Address:
Permitting Contact:

Buck Barnhart
Company:

Barnhart Agency, Inc.
Address:

212 W. 13th Street
Pueblo, CO 81003

Phone Number:

[phone]
Fax Number: [phone]
Email Address:
Inspection Contact:

Louis Vezzani
Company:

Walsenburg Sand & Gravel Co.,
Inc.

Address:

Hwy. 10
Walsenburg, CO 81089

Phone Number:

[phone]
Fax Number: [phone]
Email Address:

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