Laserfiche WebLink
Page 5 of 5 <br />Division records indicate the following permittee contact information. If this information is not current, please type or print <br />current contact information: <br />Permittee Contact: <br />Richard Coulson <br />Permittee Company: <br />Coulson Excavating Company, <br />Inc. <br />Address: <br />3609 North County Road 13 <br />Loveland, CO 80538 <br />Phone Number: <br />(970) 667-2178 <br />Fax Number: <br />(970) 667-2193 <br />Email Address: <br />! ' . . n :. ; • - <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 accordance • the 5. I approve ping a s reclamation plans. <br />/CA0/6-- <br />Signature of Pdr irh t e C rporate Officer, Owner, or Documented Designee Date <br />M -AF -01 <br />