2017-07-25_REPORT - M1980020

• Permit No: M1980020
• IBM Index Class Name: REPORT
• Doc Date: 7/25/2017
• Doc Name: Annual Fee/Report/Map
• From: ARS Sand & Gravek Co LLC
• To: DRMS
• Annual Report Year: 2016
• Email Name: PSH
• 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: Roy Mayfield
Permittee Compam: ARS Sand&Gravel Co LLC
Address: 8505 W. Mtn. View Ln.
Littleton. CO 80125
Phone Number: [phone]
Fax Number: [phone]
Email Address: Rmayfieldnaarscompanies.com
Permitting Contact: Kim Haarberg
Company: ARS Sand& Gravel Co LLC
Address: 8505 W. Mtn. View Ln.
Littleton, CO 80125
Phone Number: [phone]
Fax Number:
Email Address:
Inspection Contact: Kim I laarberg
Company: ARS Sand&Gravel Co LLC
Address: 8505 W. Mtn. View Ln.
Littleton, CO 80125
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 Co orate Officer,Owner,or Documented Designee Date
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