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 />Shad Peabody <br />333 Sc.C.N t e_Pkr— <br />Permittee Company: <br />Skanska USA Civil West Rocky <br />Mountain District Inc. <br />Address: <br />22419 CR G <br />P.O. Box 1660 <br />Cortez, CO 81321 <br />Phone Number: <br />(970) 529-2128 <br />Fax Number: <br />(970) 565-0188 <br />Email Address: <br />Shad.peabody@skanska.com <br />ryry� 1 <br />-�-Oaa, 1 e *�--e�" c. Skc�6 --A c_ . <br />, <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 />r <br />Signature of Permittee % por ate Officer, Owner, or Documented Designee Date <br />M -AF -01 <br />