2017-05-16_REPORT - M2010034

• Permit No: M2010034
• IBM Index Class Name: REPORT
• Doc Date: 5/16/2017
• Doc Name: Returned Mail
• From: DRMS
• To: Syzygy Enterprises, LLC
• Email Name: ECS
• 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: Rick Miller
Permitfee Company: Syzygy Enterprises LLC
Address: 2519 1 lth Ave Unit A Box 223
Greeley, CO 80631
Phone Number: [phone]
Fax Number:
Email Address:
Permitting Contact: Rick Miller
Company: Syzygy Enterprises LLC
Address: 2519 11th Ave Unit A Box 223
Greeley, CO 80631
Phone Number: [phone]
Fax Number:
Email Address:
Inspection Contact: Rick Miller
Company: Syzygy Enterprises LLC
Address: 2519 lth Ave Unit A Box 223
Greeley,CO 80631
Phone Number: [phone]
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