2017-10-16_REPORT - M2009077

• Permit No: M2009077
• IBM Index Class Name: REPORT
• Doc Date: 10/16/2017
• Doc Name: Annual Fee/Report/Map
• From: Tracy & Ed Grimes
• To: DRMS
• Annual Report Year: 2017
• 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: Tracy or Ed Grimes
Permittee Company: Tracy and Ed Grimes
Address: 47570 Hwy. 24
P0 Box 399
Limon, CO 80828
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: Bruce Humphries
Company: Regulatory Permits Management
Inc.
Address: 22151 E. Euclid Pl.
Aurora,CO 80016
Phone Number: [phone]
Fax Number:
Email Address: [e-mail]
Inspection Contact: Tracy or Ed Grimes
Company: Yucca Ridge Sand&Gravel
Address: 47570 Hwy. 24
P0 Box 399
Limon, CO 80828
Phone Number: [phone]
Fax Number: [phone]
Email Address:
'f D I'd Pilo
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I,the undersigned, hereby state tha e information rovided 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 Pe mittee Corp-
or orate Officer,Owner,or Documented Designee Date
M-AF-01