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Page 5 of 5 <br />Division records indicate the following permittee contact information. If this information is not current, please type or <br />print current contact information: <br />Permittee Contact: <br />JordanSasser <br />Permittee Company: <br />All -Rite Paving & Redi-Mix Inc. <br />Address: <br />P.O. Box 165 <br />Canon City, CO81212 <br />Phone Number: <br />(719) 275-1280 <br />Fax Number: <br />(719) 275-8897 <br />Email Address: <br />, <br />C�.t � G�1'ti Corfu• C'o w, <br />I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are <br />being conduoxon accordar;ge with the Division approved mining and reclamation plans. <br />� L -V I 30 I IS <br />Signatur fPermittee, Corpor icer, Owner, or Documented Desil4nee Date <br />M -AF -01 <br />