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• <br />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: i Mr. John Sliman <br />Permittee Company: Southwest Farms. Inc. <br />Address: 1825 Chianti <br />Pueblo. CO 81001 <br />Phone Number: <br />Fax Number: <br />CF. PR. telephone_number <br />Email Address: <br />1, the undersigned, hereby s <br />being conducted in accor <br />i <br />th the information provided in this report is true and accurate. and that site operations are <br />ce > th he Division approved mining and reclamation plans. <br />/(-/3 <br />Signat of Permittee, Corporate Officer. Owner, or Documented Designee Date <br />b o,, MARIA GUTIERREZ <br />�'..s Notary Public - State of Florida 1 <br />My Comm. Expires Mar 12. 2018 0 <br />''%Fo��a.. Commission # FF 100939 <br />'�nu <br />