2017-09-11_REPORT - M2015006

• Permit No: M2015006
• IBM Index Class Name: REPORT
• Doc Date: 9/11/2017
• Doc Name: Annual Fee/Report/Map
• From: Sprague Stone LLC
• To: DRMS
• Annual Report Year: 2016
• Email Name: JLE
• 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: Matthew Sprague
Permittee Company: Sprague Stone LLC
Address: P O Box 294
Masonville,CO 80541
Phone Number: [phone]
Fax Number:
Email Address:
Permitting Contact: Matthew Sprague
Company: Sprague Stone LLC
Address: P O Box 294
Masonville,C) 80541 M41S.6 v >>Q C
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Phone Number: [phone]
Fax Number:
Email Address:
Inspection Contact: Matthew Sprague
Company: Sprague Stone LLC
Address: P O Box 294
Masonville,CO 80541
Phone Number: [phone]
Fax Number:
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 accordance with the Division approved mining and reclamation plans.
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Signature of Permittee.ttoriporate Officer,Owner,or Documented Designee Date
M-AF-0