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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: Michael T.Mordi <br /> Permittee Company: Routt County <br /> Address: P.O. Box 773598 <br /> Steamboat Springs, CO 80477 <br /> Phone Number: (970) 870-5337 <br /> Fax Number: (970) 879-3992 <br /> Email Address: Mmordi@co.routt.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 Divisio .proved mining and reclamation plans. <br /> • <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-04 <br />