2017-01-17_REPORT - M1988044

• Permit No: M1988044
• IBM Index Class Name: Report
• Doc Date: 1/17/2017
• Doc Name: Annual Fee/Report Notice
• From: DRMS
• To: Schmidt Construction
• 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 Davis
Permittee Company:

Schmidt Construction Company
Address:

2635 Delta Dr.
Colorado Springs, CO 80910

Phone Number:

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

Mark A. Heifner
Company:

Southwestern Ecological
Services

Address:

37 E. Colorado Ave.
Denver, CO 80210

Phone Number:

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

Donald Opheim
Company:

Schmidt Construction Company
Address:

1101 Topeka Way
Castle Rock, CO 80104

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