2017-08-30_M1989092_Annual Fee Notice ARCHIVE

• Permit No: M1989092A
• IBM Index Class Name: Report
• Doc Date: 8/30/2017
• Doc Name: Annual Fee Notice
• From: DRMS
• To: Oaklands Ranch
• 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:

David Curtis
Permittee Company:

Oaklands Ranch
Address:

1613 N Perry Park Rd
Sedalia, CO 80135-8511

Phone Number:

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

David Curtis
Company:

Oaklands Ranch
Address:

1613 N Perry Park Rd
Sedalia, CO 80135

Phone Number:

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

David Curtis
Company:

Oaklands Ranch
Address:

1613 N Perry Park Rd
Sedalia, CO 80135

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