2017-06-22_REPORT - M1995095

• Permit No: M1995095
• IBM Index Class Name: REPORT
• Doc Date: 6/22/2017
• Doc Name: Annual Fee/Report/Map
• From: Schuler Terracing
• To: DRMS
• Annual Report Year: 2017
• Email Name: TC1
• Email Name: WHE
• Email Name: AJW
• 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: Henry A. Schuler
Permittee Company: Schuler Terracing
Address: P.O. Box 398
Simla, CO 80835
Phone Number: [phone]
Fax Number:
Email Address:
Permitting Contact: Henry A. Schuler
Company: Schuler Terracing
Address: P.O. Box 398
Simla, CO 80835
Phone Number: [phone]
Fax Number:
Email Address:
Inspection Contact: Henry A. Schuler
Company: Schuler Terracing
Address: P.O. Box 398
Simla, CO 80835
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 Divi ion a proved mining and reclamation plans.
9UAU- 7
Signature of Permittee C r#rate Officer,Owner,or Documented Designee Date
M-AF-01