2017-07-18_REPORT - M2011009

• Permit No: M2011009
• IBM Index Class Name: REPORT
• Doc Date: 7/18/2017
• Doc Name: Annual Fee/Report/Map
• From: IGWT Mining
• To: DRMS
• Annual Report Year: 2016
• Email Name: MAC
• 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: Mike London
Permittee Company: IGWT Mining, Inc.
Address: P.O. Box 622001
Littleton, CO 80162
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: Rhoda London
Company: IGWT Mining, Inc.
Address: P.O. Box 270328 �0 t3n� �, 1 1 o O
Littleton, CO 80127 /
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Inspection Contact: Mike London
Company: IGWT Mining, Inc.
Address: P.O. Box 270328 Po Box 6 1 10 0 l
Littleton, CO 80127 {{ /
9o / 6
Phone Number: [phone]
Fax Number: [phone]
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 accordance with the Division approved mining and reclamation plans.
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Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date
M-AF-02