2017-01-17_REPORT - M2014063

• Permit No: M2014063
• IBM Index Class Name: Report
• Doc Date: 1/17/2017
• Doc Name: Annual Fee/Report Notice
• From: DRMS
• To: White River City Investments
• 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:

Don Valentine
Permittee Company:

White River City Investments
LLC

Address:

P.O. Box 881090
Steamboat Springs, CO 80488

Phone Number:

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

J. Leif Joy
Company:

JSC, Inc dba Joy Surveying
Company

Address:

646 Main Street
P.O. Box 1153
Meeker, CO 81641

Phone Number:

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

Don Silva
Company:

White River City Investments
LLC

Address:

P.O. Box 519
Hayden, CO 81639

Phone Number:

[phone]
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.

Signature of Permittee, Corporate Officer, Owner, or Documented Designee Date
M-AF-01