Laserfiche WebLink
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 />MarkMartin <br />Permittee Company: <br />Asphalt Paving Company <br />Address: <br />14802 W 44th Ave <br />Golden, CO80403 <br />Phone Number: <br />(303) 279-6611 <br />Fax Number: <br />(303) 279-6216 <br />Email Address: <br />I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are <br />being conducted in accordance with the Division approved mining and reclamation plans. <br />712 <br />Signature ofPermittee, Corporate Officer, Owner, or Documented Designee Date <br />M -AF -01 <br />