2017-10-24_REPORT - M2004008

• Permit No: M2004008
• IBM Index Class Name: REPORT
• Doc Date: 10/24/2017
• Doc Name: Annual Fee/Report/Map
• From: Joseph Harden
• To: DRMS
• Annual Report Year: 2017
• Email Name: MAC
• 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. Harden
Permittee Company: Joseph Curtis Harden
Address: P.O. Box 1207
Idaho Springs, CO 80452
Phone Number: [phone]
Fax Number:
JVdr
Email Address:
Permitting Contact: Joseph C. Harden
Company: Joseph Curtis Harden
Address: P.O. Box 1207
Idaho Springs, CO 80452
Phone Number: [phone]
Fax Number: ASP dA
Email Address: M /A
Inspection Contact: Joseph C.Harden
Company: Joseph Curtis Harden
Address: P.O. Box 1207
Idaho Springs, CO 80452
Phone Number: [phone]
Fax Number: X'F
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.
/Q-fy- L Q + -7
Si nature of Permittee,Corporate Officer,Owner,or Documented Designee Date
M-AF-02