2017-08-30_M2002111_Annual Fee Notice ARCHIVE

• Permit No: M2002111A
• IBM Index Class Name: Report
• Doc Date: 8/30/2017
• Doc Name: Annual Fee Notice
• From: DRMS
• To: Fruita Development LLC
• Annual Report Year: 2017
• Media Type: D
• Archive: Yes

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:

Douglas Brown
Permittee Company:

Fruita Development LLC
Address:

11990 San Vicente Boulevard,
Suite 200
Los Angeles, CA 90049

Phone Number:

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

Nicole Stanton
Company:

Fruita Development LLC
Address:

11990 San Vicente Boulevard,
Suite 200
Los Angeles, CA 90049

Phone Number:

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

Nicole Stanton
Company:

Fruita Development LLC
Address:

11990 San Vicente Boulevard,
Suite 200
Los Angeles, CA 90049

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