Laserfiche WebLink
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: Harold R.Roberts <br /> Permittee Company: Energy Fuels Resources(USA) <br /> Inc. <br /> Address: 225 Union Blvd., Suite 600 <br /> Lakewood, CO 80228 <br /> Phone Number: (303)389-4160 <br /> Fax Number: (3 0 3) 974-2 14 1 <br /> Email Address: <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 /> W-4c, <br /> gnature of Permittee,Corporate Officer,Owner,or Documented Designee i3Tte <br /> M-AF-02 <br />