2017-08-01_REPORT - M2009038

• Permit No: M2009038
• IBM Index Class Name: REPORT
• Doc Date: 8/1/2017
• Doc Name: Annual Fee/Report/Map
• From: Urie Rock Company
• To: DRMS
• Annual Report Year: 2016
• Email Name: THM
• 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: Elaine Urie
Permittee Company: Urie Rock Company
Address: 2424 East Main Street
Rangely, CO 81648
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: Jonathan L.Joy
Company: �T� -4ne. M
Address: 646 Main Street
PO Box 1153
Meeker,CO 81641
Phone Number: [phone]
Fax Number: [phone]
Email Address: (_.e i. j
Inspection Contact: Stephen Urie J
Company: Urie Rock Company
Address: 2424 East Main Street
Rangely, CO 81646
Phone Number: [phone]
Fax Number: (q7o) 05-Zd 13
Email Address:
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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 ision approved mining and reclamation plans.
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Signature of Permittee,Cori) to Officer,Owner,or Documented Designe bate
NI-AF-01