2017-06-29_M2009038_Annual Fee Notice ARCHIVE

• Permit No: M2009038A
• IBM Index Class Name: Report
• Doc Date: 6/29/2017
• Doc Name: Annual Fee Notice
• From: DRMS
• To: Urie Rock Company
• Annual Report Year: 2017
• Media Type: D
• Archive: Yes

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:

Elaine Urie
Permittee Company:

Urie Rock Company
Address:

2424 East Main Street
Rangely, CO 81648

Phone Number:

[phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact:

Jonathan L. Joy
Company:

JSC, Inc.
Address:

646 Main Street
PO Box 1153
Meeker, CO 81641

Phone Number:

[phone]
Fax Number: [phone]
Email Address:
Inspection Contact:

Stephen Urie
Company:

Urie Rock Company
Address:

2424 East Main Street
Rangely, CO 81646

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 Division approved mining and reclamation plans.

Signature of Permittee, Corporate Officer, Owner, or Documented Designee Date
M-AF-01