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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: Melanie Bounds <br /> Permittee Company: Huerfano County <br /> Address: 401 Main Street, Suite 101 <br /> Walsenburg, CO 81089 <br /> Phone Number: (719)738-3000 <br /> Fax Number: (719)738-3996 <br /> Email Address: <br /> I,the underigned, ereby state at the information provided in this report is true and accurate,and that site operations are <br /> being condu ted i accordanc; wi the Division approved mining and reclamation plans. <br /> iL <br /> !Ato .. ... 4 .Z2 . ftc <br /> Si nature Perw ,.� ., Officer,Owner,or Documented Designee Date <br /> M-AF Idi& <br /> - <br />