2017-07-18_REPORT - M1984094

• Permit No: M1984094
• IBM Index Class Name: REPORT
• Doc Date: 7/18/2017
• Doc Name: Annual Fee/Report/Map
• From: Sanborn S & G
• 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: Jodi Fitzpatrick
Permittee Company: Sanborn Sand and Gravel/dba
Golden Cross Aggregates, Inc.
Address: 601 Bath Street
Metairie, LA 70001
Phone Number: [phone]
Fax Number:
Email Address: [e-mail]
Permitting Contact: Michael Pfister
Company: Sanborn Sand and Gravel DBA
Golden Cross Aggregates, Inc.
Address: P O Box 1180
Alma, CO 80420
Phone Number: [phone]
Fax Number:
Email Address:
Inspection Contact: Michael Pfister
Company: Sanborn Sand and Gravel DBA
Golden Cross Aggregates,Inc.
Address: P O Box 1180
Alma,CO 80420
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.
Sign re of Per mZi'1q1i3XorPorate Officer,Owner,or Documented Designee Date
M•AF-01