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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 />Stanley C. Jones <br />Permittee Company: <br />Colorado Alabaster Supply <br />Address: <br />P O Box 548 <br />Fort Collins, CO 80522-0548 <br />Phone Number: <br />(970) 221-0723 <br />Fax Number: <br />(970) 221-0723 <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 />Signature of Permittee, Corporate Officer, Owner, or Documented Designee <br />M -AF -02 <br />8=-2y---2aJS <br />Date <br />