2017-03-17_REPORT - M1977211

• Permit No: M1977211
• IBM Index Class Name: Report
• Doc Date: 3/17/2017
• Doc Name: Annual Fee/Report Notice
• From: DRMS
• To: Continental Materials
• 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:

Martin L. Shafer
Permittee Company:

Continental Materials
Corporation

Address:

444 E. Costilla St.
Colorado Springs, CO 80903

Phone Number:

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

Andre LaRoche
Company:

Continental Materials Corp dba
Transit Mix Concrete Co.

Address:

444 E. Costilla
Colorado Springs, CO 80903

Phone Number:

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

Martin (Mac) L. Shafer
Company:

Continental Materials Corp dba
Transit Mix Aggregates

Address:

444 E. Costilla
Colorado, CO 80903

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