2017-08-28_REPORT - M2009004

• Permit No: M2009004
• IBM Index Class Name: REPORT
• Doc Date: 8/28/2017
• Doc Name: Annual Fee/Report/Map
• From: Rocky Mountain Materials and Asphalt, Inc.
• To: DRMS
• Annual Report Year: 2017
• Email Name: TC1
• Media Type: D
• Archive: No

Page 5 of5
Division records indicate the follow ing permittee landowner contact information (blank fields indicate that we do not ha\e
information on record). If this information is blank or not current. please type or print current contact information:
Permittee Contact: David Bieber
Permittee Company: Rocky Mountain Materials and
Asphalt. Inc.
Address: Co Martin Marietta Materials,
Inc.
1627 Cole Boulevard. Suite 200
Lakewood. CO 80401
Phone Number: [phone] [phone]
Fax Number: [phone]
Email Address: David.bieber'u martinmarietta.com
Permitting Contact: David Bieber
Company: Rocky Mountain Materials, Inc.
Address: C/o Martin Marietta Materials,
Inc.
1627 Cole Boule\ard. Suite 200
Lakewood, CO 80401
Phone Number: [phone] [phone]
Fax Number: [phone]
Email Address: David.bieberrirmartinmarietta.com
Inspection Contact: Da\id Bieber
Company: Rocky Mountain Materials, Inc.
Address: Co Martin Marietta Materials,
Inc.
1627 Cole Boulevard, Suite 200
Lakewood, CO 80401
Phone Number: [phone] [phone]
Fax Number: [phone]
Email Address: [e-mail]
I.the undersigned, hereby state that the information provided in this report is true and accurate. and that site operations are
being conducted in acs, rdai ce ith the 1)n isi 1 approved mining and reclamation plans,
/ (42 AL
August 22. 20)7
Signature of Permittee, Corporate Officer, Owner, or Documented Designee Date
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