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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: Bill Tenore <br /> Permittee Company: T Bone Stone, Inc. <br /> Address: 2337 Emery St <br /> Longmont, CO 80501 <br /> Phone Number: (303)324-5023 <br /> Fax Number: (303)776-3839 <br /> Email Address: Tbonestoneinc@msn.com <br /> 1,the undersigned h reby state t r€ett►ation provided in this report is true and accurate, and that site operations are <br /> being co ed in or e with the Divisi n approved mining and reclamation plans. <br /> r ,r_ <br /> Z!a�ture ate Officer,Owner,or Documented Designee Date <br />