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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 print <br />current contact information: <br />Permittee Contact: <br />Melanie Bounds <br />Permittee Company: <br />Huerfano County <br />Address: <br />401 Main St., Ste. 105 <br />Walsenburg, CO 81089 <br />Phone Number: <br />(719) 738-3053 <br />Fax Number: <br />(719) 738-3996 <br />Email Address: <br />Mbounds@huerfano.us <br />I, the u dersigne hereby stat at the information provided in this report is true and accurate, and that site operations are <br />being co ducted accordthe Division approved mining and reclamation plans. <br />Signa <br />ure of <br />k. <br />12. <br />fficer, Owner, or Documented Designee Date <br />