2017-05-26_REPORT - M2015003

• Permit No: M2015003
• IBM Index Class Name: REPORT
• Doc Date: 5/26/2017
• Doc Name: Annual Fee/Report/Map
• From: The New Cache La Poudre Irrigating Company
• To: DRMS
• Annual Report Year: 2016
• Email Name: PSH
• 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: Dale Trowbridge
Permittee Company: The New Cache La Poudre
Irrigating Company
Address: 33040 Railroad Ave
Lucerne, CO 80646
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: Dale Trowbridge
Company: The New Cache La Poudre
Irrigating Company
Address: 33040 Railroad Ave
Lucerne, CO 80646
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Inspection Contact: Dale Trowbridge
Company: The New Cache La Poudre
Irrigating Company
Address: 33040 Railroad Ave
Lucerne, CO 80646
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
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.
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Signature of Permittee,Corporate Ofter,Owner,or Documented Designee Date
M-AF-01