2017-11-28_REPORT - M1985165

• Permit No: M1985165
• IBM Index Class Name: REPORT
• Doc Date: 11/28/2017
• Doc Name: Annual Fee/Report/Map
• From: Arthur A. Winter
• 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: Arthur A.Winter
Permittee Company: Arthur A. Winter
Address: 20157 C. R. 75.0
Trinidad, CO 81082 aa 10 Co Rd 1'5.c
( dad. Co ,8 IO
Phone Number: [phone]
( 2) PD '7
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: Arthur A.Winter
Company: Arthur A. Winter
Address: 20157 C. R. 75.0 . �� l 11
Trinidad, CO 81082 ao \ ,(_,,\ Co
17 nldctd Co � IO�
Phone Number: [phone] t.- q_ g5q S
Fax Number:
Email Address:
Inspection Contact: Arthur A.Winter
Company: Arthur A.Winter
Address: 20157 C. R. 75.0 I CO (d 'y 5 .r1
Trinidad, CO 81082 ` (� ,` I lJ
n ► dad CC10 &
Phone Number: [phone] 0150
1 I q_ X54 -4-8x5
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.
LtZA,. .._ I l a I - `1
Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date
M-AF-01