2017-06-19_REPORT - M1987143

• Permit No: M1987143
• IBM Index Class Name: REPORT
• Doc Date: 6/19/2017
• Doc Name: Annual Fee/Report/Map
• From: CRG Mining, LLC
• To: DRMS
• Annual Report Year: 2017
• Email Name: DMC
• 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: Robert Gydesen
Permittee Company: CRG Mining, LLC
Address: 502 S. Wisconsin Street
Gunnison, CO 81230
Phone Number: [phone]
Fax Number:
Email Address:
Permitting Contact: Robert Gydesen
Company: CRG Mining,LLC
Address: 502 S. Wisconsin Street
Gunnison, CO 81230
Phone Number: [phone]
Fax Number:
Email Address:
Inspection Contact: Robert Gydesen �J'(1.
1
Company: CRG Mining, LLC �C
Address: 502 S. Wisconsin Street
Gunnison, CO 81230
Phone Number: [phone]
Fax Number: T
Email Address: @ f`U/VI
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 e Division approved mining and reclamation plans.
Signature of PermitkeeXornorate Officer,Owner,or Documented Deshme 6ate
M-AF-02