2017-01-17_REPORT - M1978268

• Permit No: M1978268
• IBM Index Class Name: Report
• Doc Date: 1/17/2017
• Doc Name: Annual Fee/Report Notice
• From: DRMS
• To: Ouray County
• 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:

Chris Miller
Permittee Company:

Ouray County
Address:

P.O. Box 456
Ridgway, CO 81432

Phone Number:

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

Douglas Conger
Company:

Geological Services
Address:

711 Hartman Rd.
Cortez, CO 81321

Phone Number:

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

Bob Wolford
Company:

Ouray County Road & Bridge
Department

Address:

P.O. Box 456
Ridgway, CO 81432-0456

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-04