2017-07-18_REPORT - M1981002

• Permit No: M1981002
• IBM Index Class Name: REPORT
• Doc Date: 7/18/2017
• Doc Name: Annual Fee/Report/Map
• From: Town of Crested Butte
• To: DRMS
• Annual Report Year: 2016
• 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: Rodney E. Due
Permittee Company: Town of Crested Butte
Address: 507 Marroon Ave.
P.O. Box 39
Crested Butte, CO 81224
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Permitting Contact:
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Company: Town of Crested Butte
Address: P.O. Box454-- '
Crested Butte,CO 81224
Phone Number: [phone]
Fax Number:
Email Address:
Inspection Contact:
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Company: Town of Crested Butte
Address: P.O. Box.14�
Crested Butte, CO 81224
Phone Number: [phone]
Fax Number:
Email Address:
I,the undersigned,her y state ihat the information provided in this report is true and accurate,and that site operations are
being conducted in cordance with the Division approved mining and reclamation plans.
�— 7//2
Signature of Permittee or orate Officer,Owner,or Documented Designee Date
M-AF-04