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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: Christie Coleman <br /> Anastasia Frantsova <br /> Permittee Company: City of Greeley <br /> Address: 1100 1Oth Street, Suite 300 <br /> Greeley,CO 80631 <br /> Phone Number: (303)350-3209 (303) 350-9806 <br /> Fax Number: <br /> Email Address: <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 /> ���✓�50d2- ��z 3 Zo/6 <br /> Signature of Permittee,Coraorate Officer,Owner,or Documented Designee Date <br /> M-,u-a <br />