2017-11-30_REPORT - M1978314

• Permit No: M1978314
• IBM Index Class Name: REPORT
• Doc Date: 11/30/2017
• Doc Name: Annual Fee/Report/Map
• From: Hewes Family, LLLP
• To: DRMS
• Annual Report Year: 2017
• Email Name: GRM
• Media Type: D
• Archive: No

Page 3 of3
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 prim current contact information.
Tcr>�eeC�ot I�"�cli� ,
Permittee Company: Hewes Family LLLP
Address: PO Box E
Toponas, CO 80479
Phone Number: [phone]
Fax Number:
Email Address:
Permitting Contact: Frank Hewes
Company: Helves Famiy LLLP
Address: 28655 CR#5
Toponas,CO 80479
Phone Number: [phone]
Fax Number:
Email Address:
Inspection Contact: Frank Hewes
Company: Hewes Famiy LLLP
Address: 28655 CR#5
Toponas,CO 80479
Phone Number: [phone]
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.
A—C) t O
Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date
M-AF-01