2017-04-24_REPORT - M2006046

• Permit No: M2006046
• IBM Index Class Name: REPORT
• Doc Date: 4/24/2017
• Doc Name: Annual Fee/Report/Map
• From: Silt Sand & Gravel, LLC
• To: DRMS
• Email Name: ACY
• 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: Sean Mello
Permittee Company: Silt Sand&Gravel,LLC
Address: P.O. Box 1319
Carbondale,CO 81623
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: �o G C
Company: , LC Cz2t co < <.� c.k..% P��o fi b S o c.t,&--r 4 S
Address: 7 , ite 117
La 0215 \!� \r'`� A RR'„� �' T''J
Phone Number: [phone] I Z b _ g 3 Z - S 15-L I
Fax Number: [phone]
Email Address: 'F=,,L 0 L, L.1`. w �c ,, Z
Inspection Contact:
Company: Silt Sand&Gravel,LLC
Address: 40*tf"nvay-t33 T O a C>Y-
G .t.,.nd 1, Cn o'623
�azA, ,.� oA. ak\- z 3
Phone Number: [phone]
Fax Number: [phone]
Email Address: 5 C �`o ,� S _ 6.-Pr,Z1-kPL
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