2017-04-28_REPORT - M1981057

• Permit No: M1981057
• IBM Index Class Name: Report
• Doc Date: 4/28/2017
• Doc Name: Annual Fee Notice
• From: DRMS
• To: ARKINS PARK STONE CORPORATION
• 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:

Judy Sprague
Permittee Company:

ARKINS PARK STONE
CORPORATION

Address:

5975 NCR 27
Loveland, CO 80538

Phone Number:

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

Judy Sprague
Company:

Arkins Park Stone Corp.
Address:

5975 NCR 27
Loveland, CO 80538

Phone Number:

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

Judy Sprague
Company:

Arkins Park Stone Corp.
Address:

5975 NCR 27
Loveland, CO 80538

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