2017-07-26_REPORT - M1977302

• Permit No: M1977302
• IBM Index Class Name: Report
• Doc Date: 7/26/2017
• Doc Name: Annual Fee Notice
• From: DRMS
• To: Pete Lien & Sons, Inc.
• Annual Report Year: 2017
• 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:

Clint Beck
Permittee Company:

Pete Lien & Sons, Inc.
Address:

P.O. Box 440
Rapid City, SD 57709-0440

Phone Number:

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

Danielle Wiebers
Company:

Pete Lien & Sons, Inc.
Address:

3401 Universal Dr.
P.O. Box 440
Rapid City, CO 57701

Phone Number:

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

Brian Tideman
Company:

Pete Lien & Sons, Inc.
Address:

P.O. Box 1961
Fort Collins, CO 80225-1961

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