2017-10-11_REPORT - M1987074

• Permit No: M1987074
• IBM Index Class Name: REPORT
• Doc Date: 10/11/2017
• Doc Name: Annual Fee/Report/Map
• From: Mayne Block & Stone
• To: DRMS
• Annual Report Year: 2017
• Email Name: THM
• 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: Joseph C. Welte
Permittee Company: Mayne Block& Stone Company
Address: P.O. Box 533
Pueblo,CO 81002
Phone Number: [phone]
Fax Number:
Email Address:
Permitting Contact: Joseph C. Welte
Company: Mayne Block&Stone Company
Address: P.O. Box 533
Pueblo, CO 81002
Phone Number: [phone]
Fax Number:
Email Address:
Inspection Contact: Joseph C. Welte
Company: Mayne Block&Stone Company
Address: P.O. Box 533
Pueblo, CO 81002
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.
6izt� r�>a Cap
Signatu a of Permittee,Corporate Officer,Owner,or Documented Designee Date
M-AF-01