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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: Mike Mordi <br /> Permittee Company: Routt County <br /> Address: 136 6th Street <br /> P.O. Box 773598 <br /> Steamboat Springs, CO 80477 <br /> Phone Number: (970)870-5552 <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 Division approved mining and reclamation plans. <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Desisnee Date <br /> M-AF-04 <br />