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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 />Kane Schneider <br />Permittee Company: <br />Colorado Department of <br />Transportation <br />Address: <br />606 S. 9th St. <br />Grand Junction, CO 81501 <br />Phone Number: <br />(970) 683-6308 <br />Fax Number: <br />(970) 683-6340 <br />Email Address: <br />Kane.schneider@state.co.us <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 />-7o - l,C� <br />Permittee, Corporate Officer, Owner, or Documented Designee Date <br />M -A -04 <br />