2017-03-23_REPORT - M1993030 ‎(5)‎

• Permit No: M1993030
• IBM Index Class Name: Report
• Doc Date: 3/23/2017
• Doc Name: Annual Fee/Report/Map
• From: Joseph L. Dorris
• To: DRMS
• Annual Report Year: 2017
• Email Name: ERR
• 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:
Joseph L. Dorris
Permittee Company:
Glacier P Art, Gems & Minerals
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r
Address:
2920 Cedar Heights Dr.
Colorado Springs, CO 80904
Phone Number:
(719) 6854479
Fax Number:
Email Address:
[e-mail]
rP @P�innacle5minerals.com
Permitting Contact:
Joseph L. Dorris
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ren
Company:
Glacier P Art, Gems & Minerals
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Address:
2920 Cedar Heights Dr.!
Colorado Springs, CO 80904
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Phone Number:
[phone]
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s
Fax Number:
Email Address:
Inspection Contact:
Joseph L. Dorris
Company:
Gem s &Minerals
Glacier !e�'
Address:
2920 Cedar Heights Dr.
Colorado Springs, CO 80904
Phone Number:
(719) 6854479
Fax Number:
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.
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of Permittee. Corporate Officer, Owner, or Documented Documented Designee
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Date