2017-03-17_REPORT - M2006031

• Permit No: M2006031
• IBM Index Class Name: Report
• Doc Date: 3/17/2017
• Doc Name: Annual Fee/Report Notice
• From: DRMS
• To: Steel Rose
• Annual Report Year: 2017
• Permit Index Doc Type: Annual Fee/Report
• 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:

Scott B. West
Permittee Company:

Steel Rose I. Inc.
Address:

802 3rd St.
Colorado Springs, CO 80907

Phone Number:

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

Scott B. West
Company:

Steel Rose 1
Address:

802 3rd St.
Colorado Springs, CO 80907

Phone Number:

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

Scott B. West
Company:

The Steel Rose 1, Inc.
Address:

802 3rd St.
Colorado Springs, CO 80907

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-02