2017-10-27_REPORT - M1986124

• Permit No: M1986124
• IBM Index Class Name: REPORT
• Doc Date: 10/27/2017
• Doc Name: Annual Fee/Report/Map
• From: James Cecil
• To: DRMS
• Annual Report Year: 2017
• Email Name: ECS
• 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: James Cecil
Permittee Company: James Cecil
Address: 8500 County Road AAA
Cope, CO 80812-9509
Phone Number: [phone]
Fax Number:
Email Address: [e-mail]
Permitting Contact: James Cecil
Company: James Cecil
Address: 8500 County Road AAA
Cope, CO 80812-9509
Phone Number: [phone]
Fax Number:
Email Address: [e-mail]
Inspection Contact: James Cecil
Company: JamesCecil
Address: 8500 County Road AAA
Cope, CO 80812-9509
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 conduc -d in accordance with the D'vision approved mining and reclamation plans.
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Signat • • Permittee,Corpora e Officer,Owner,or Documented Designee Date
M-AF-S