2017-08-22_REPORT - M2003002

• Permit No: M2003002
• IBM Index Class Name: Report
• Doc Date: 8/22/2017
• Doc Name: Annual Fee/Report/Map
• From: HCR High Country Repair
• To: DRMS
• Annual Report Year: 2017
• Email Name: ECS
• Media Type: D
• Archive: No

Page 5 of 5
Division records indicate the following permitteellandowner 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:
James D. Branch
Permittee Company:
HCR High Country Repair
Address:
2632 McCormick Ave.
Pueblo, CO 81001
Phone Number:
[phone]
Fax Number:
-7 1 56 g6t oZ
Email Address:
[e-mail]
Permitting Contact:
James D. Branch
Company:
HCR High Country Repair
Address:
2632 McCormick Ave.
Pueblo, CO 81001
Phone Number:
[phone]
Fax Number:
Email Address:
Inspection Contact:
James D. Branch
Company:
HCR High Country Repair
Address:
2632 McCormick Ave.
Pueblo , CO 81001
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 B ion approyxd mining and reclamation plans.
of Perm] tee, Co'.orate Officer, Owner, or Documented Designee Date