2017-02-22_REPORT - M2003068

• Permit No: M2003068
• IBM Index Class Name: REPORT
• Doc Date: 2/22/2017
• Doc Name: Annual Fee/Report/Map
• From: Craig J. Walker Revokable Trust
• To: DRMS
• Annual Report Year: 2017
• Email Name: ECS
• 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: Craig J. Walker
Permittee Company: Craig J. Walker Revocable Trust
Address: 420 E. 58th Ave., Ste.200
Denver, CO 80216
Phone Number: [phone]
Fax Number:
Email Address:
Permitting Contact: Mary Shaw Canda
Company: Craig J. Walker Revocable Trust
Address: P.O. Box 521
Aguilar, CO 81020
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Inspection Contact: Mary Shaw Canda
Company: Craig J. Walker Revocable Trust
Address: P.O. Box 521
Aguilar, CO 81020
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 Di ion approved mining and reclamation plans.
I
Signature o er i or ra a ker, n ,or Documented Desiunee Date
M-AF-01 Q �'\�