2017-06-02_REPORT - M1985022

• Permit No: M1985022
• IBM Index Class Name: Report
• Doc Date: 6/2/2017
• Doc Name: Annual Fee/Report/Map
• From: Eagle Peaks Mining
• To: DRMS
• Annual Report Year: 2017
• Email Name: MAC
• Media Type: D
• Archive: No

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Division records indicate the following permitteellandowner 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 Tunstall
Permittee Company:
Eagle Peaks Mining LLC
Address:
541 Cox Lane
Howard, CO 81233
Phone Number:
[phone]
Fax Number:
Email Address:
[e-mail]
Permitting Contact:
Stephanie Tunstall
Company:
Eagle Peaks Mining, LLC
Address:
541 Cox Cane
Howard, CO 81233
Phone Number:
(719) 9424607
Fax Number.
Email Address:
[e-mail]
yahoo.com
Inspection Contact:
Stephanie Tunstall
Company:
Eagle Peaks Mining, LLC
Address:
541 Cox Lane
Howard, CO 81233
Phone Number:
[phone]
Fax Number:
Email Address:
[e-mail]
1, 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.
�k.412 1' 0-
of P rmittee Cor orate Officer, Owner, or Documented Designee Date
I-110,01