2017-06-06_REPORT - M1982036

• Permit No: M1982036
• IBM Index Class Name: Report
• Doc Date: 6/6/2017
• Doc Name: Annual Fee/Report/Map
• From: Peabody Sage Creek Mining, LLC
• To: DRMS
• Annual Report Year: 2016
• Email Name: ACY
• 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: Jerry Nettleton
ermittee Company: Peabody Sage Creek Mining,
LLC
Address: 29515 RCR27
Oak Creek,CO 80467
Phone Number: [phone]
Fax Number:
Email Address: [e-mail]
Permitting Contact: Mike W.bud!
Company: Peabody Sage Creek Mining
LLC ,
Address:
Phone Number: E940)2q6-g66i
Fax Number:
Email Address:
Inspection Contact: Wk `I' I ttdi
Company: Peabody Sage Creek Mining
LLC
Address: 36690 Reutt ecanty RVdd#2T ;
Wa34en;GE) H639 4p,
PIP��bdG
y
Phone Number: ( 6}246-740+
Fax Number:
Email Address:
1,the undersigned,hereby state that the information provided in this report is true and accurate, and that site operations are
being conducted in accord the Division approved mining and reclamation plans.
Signature o ermi ee ate Officer,Owner,or Documented Desicnee Date
M-AF-01