2017-04-28_REPORT - M2002118

• Permit No: M2002118
• IBM Index Class Name: Report
• Doc Date: 4/28/2017
• Doc Name: Annual Fee Notice
• From: DRMS
• To: APC Southern Construction Co., LLC
• Annual Report Year: 2017
• 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:

James MacDonald
Permittee Company:

APC Southern Construction Co.,
LLC

Address:

14802 W 44th Avenue
Golden, CO 80403

Phone Number:

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

Joe Gagliano
Company:

LJ Development, Inc.
Address:

256 N. Merrill Drive
Pueblo West, CO 81007

Phone Number:

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

Richard Pounds
Company:

APC Southern Construction Co.,
LLC

Address:

14802 W 44th Avenue
Golden, CO 80403

Phone Number:

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