2017-05-08_REPORT - M2006024

• Permit No: M2006024
• IBM Index Class Name: REPORT
• Doc Date: 5/8/2017
• Doc Name: Annual Fee/Report/Map
• From: Carrizo Stone
• To: DRMS
• Annual Report Year: 2016
• 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 on record). If this information is blank or not current,please type or print current contact information:
Permittee Contact: Stephanie and Ray Sikes
Permittee Company: Carrizo Stone,LLC
Address: 1425 County Road Q
Pritchett,CO 81064
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Permitting Contact: Stephanie and Ray Sikes
Company: Carrizo Stone,LLC
Address: 1425 County Road Q
Pritchett,CO 81064
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Inspection Contact: Stephanie and Ray Sikes
Company: Carrizo Stone, LLC
Address: 1425 County Road Q
Pritchett,CO 81064
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, ner,or Documented De i�nee Date
M-AF-01