2017-05-30_M1980020_Annual Fee Notice ARCHIVE

• Permit No: M1980020A
• IBM Index Class Name: Report
• Doc Date: 5/30/2017
• Doc Name: Annual Fee Notice
• From: DRMS
• To: ARS Sand & Gravel Co LLC
• Annual Report Year: 2017
• Media Type: D
• Archive: Yes

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:

Roy Mayfield
Permittee Company:

ARS Sand & Gravel Co LLC
Address:

8505 W. Mtn. View Ln.
Littleton, CO 80125

Phone Number:

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

Kim Haarberg
Company:

ARS Sand & Gravel Co LLC
Address:

8505 W. Mtn. View Ln.
Littleton, CO 80125

Phone Number:

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

Kim Haarberg
Company:

ARS Sand & Gravel Co LLC
Address:

8505 W. Mtn. View Ln.
Littleton, CO 80125

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