2017-09-20_REPORT - M1989092

• Permit No: M1989092
• IBM Index Class Name: REPORT
• Doc Date: 9/20/2017
• Doc Name: Annual Fee/Report/Map
• From: Oaklands Ranch
• To: DRMS
• Annual Report Year: 2016
• Email Name: PSH
• 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: David Curtis
Permittee Company: Oaklands Ranch
Address: 1613 N Perry Park Rd
Sedalia,CO 80135-8511
Phone Number: [phone] .� 1 G/ r'_"7-69
Fax Number: [phone] /
Email Address: O [e-mail] � 1` O
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] X'3 L/
Fax Number: 3� rfy7�7
Email Address:
oa. k I �;
I,the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are
being conducted in acc ce w* the Division approved mining and reclamation plans.
Signature of ermittee, Corporate Officer,Owner,or Documented Designee ESate
M-AF-01