2017-11-08_REPORT - M1996050

• Permit No: M1996050
• IBM Index Class Name: Report
• Doc Date: 11/8/2017
• Doc Name: Annual Fee/Report/Map
• From: R & J Yetter Sand & Gravel LLC
• To: DRMS
• Annual Report Year: 2017
• Email Name: JLE
• Media Type: D
• Archive: No

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W&TTeftesmill jMMMd
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Address: -
16757 CR 16
Atwood, CO 80722
Phone Number:
[phone]
Fax Number:
Email Address:
[e-mail]
Permitting Contact:
Jewelie Yetter
Company:
R & J Yetter Sand & Gravel
LLC
Address:
16757 CR 16
Atwood, CO 80722
Phone Number:
[phone]
Fax Number:
Email Address:
[e-mail]
Inspection Contact:
Jewelie Yetter
Company:
R & J Yetter Sand & Gravel
LLC
Address:
16757 CR 16
Atwood, CO 80722
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
beir,S conducted in accordance with the Division approved mining and reclamation plans.
Dzv-'U!%� 11.40-0
of Permittg Corporate Officer, Owner, or Documented Designee Date
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