2017-06-06_REPORT - M2002118

• Permit No: M2002118
• IBM Index Class Name: Report
• Doc Date: 6/6/2017
• Doc Name: Annual Fee/Report/Map
• From: APC Southern Construction Co., LLC
• To: DRMS
• Annual Report Year: 2016
• Email Name: ECS
• Media Type: D
• Archive: No

Page 5 of
Division records indicate the following permitteeflandowner contact information (blank- fields indicate that we do not have
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information on record). If this information is blank- or not current, please type or print current contact information:
Permittee Contact:
James MacDonald
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Permittee Company:
APC Southern Construction Co.,
LLC
—r(-
Officer Owner, or Documented Designee
Address:
14802 W 44th Avenue
Golden, CO 80403
Phone Number:
[phone]
Fax Number:
[phone]
Email Address:
[e-mail]
Permitting Contact:
Joe Gaoliano
Company:
LJ Development, Inc.
Address:
256 N. Merrill Drive
Pueblo West, CO 81007
/14.06 SrZ /Sb
Phone Number:
[phone]
Fax Number:
[phone]
70 �-47 -7023
Email Address:
[e-mail]
Inspection Contact:
Richard Pounds
Company:
APC Southern Construction Co.,
LLC
Address:
14802 W 44th Avenue
Golden, CO 80403
Phone Number:
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
2eing conducted in accordance with the Division approved mining and reclamation plans.
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tune of Permittee. orporate
—r(-
Officer Owner, or Documented Designee
Date