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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: Phil Bourassa <br /> Permittee Company: Beavers Construction Co./High <br /> Mesa Gravel L.L.C. <br /> Address: 805 North Crest Dr#101 <br /> Grand Junction,CO 81506 <br /> Phone Number: ( - U �r, b/ 7 <br /> Fax Number: _ J <br /> Email Address: 0— A T P R C, dL E 0 <br /> 1,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 Co orate Of , wner,or Documented Designee 6ate <br /> M-AF-01 <br />