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: � 54Vf- / 1/f <br /> Permittee Company: Montrose County <br /> Address: 949 N. 2nd Street <br /> Montrose,CO 81401 <br /> Phone Number: D 2�n <br /> Fax Number: <br /> Email Address: <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 /> z /-7 <br /> Signatu e o Permittee, Corpora Officer,Owner,or Documented Designee Da e <br /> M-AF-04 <br />