2017-04-04_REPORT - M2013012

• Permit No: M2013012
• IBM Index Class Name: REPORT
• Doc Date: 4/4/2017
• Doc Name: Annual Fee/Report/Map
• From: Kirkland Construction, R.L.L.P.
• To: DRMS
• Annual Report Year: 2017
• Email Name: MAC
• 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 6n record). If this information is blank or not current,please type or print current contact information:
Permittee Contact: Baxter Kirkland
Permittee Company: Kirkland Construction,R.L.L.P.
Address: P.O. Box 580
Rye,CO 81069
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Permitting Contact: Baxter Kirkland
Company: Kirkland Construction,R.L.L.P.
Address: P O Box 580
Rye, CO 81069
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Inspection Contact: Baxter Kirkland
Company: Kirkland Construction,R.L.L.P.
Address: P O Box 580
Rye,CO 81069
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.
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Signature of Permittee Co orate Officer,Owner,or Documented Designee Date
M-AF-01