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: Jack Allen <br /> Permittee Company: Allen Drilling and Excavating <br /> Address: 651 Hwy 285 <br /> P.O. Box 398 <br /> Fairplay, CO 80440 <br /> Phone Number: (719) 836-2672 <br /> Fax Number: (719) 836-0715 <br /> Email Address: Allendrilling@hughes.net <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 /> Signature of a mittee C orate Officer, Owner,or Documented Designee Date <br /> M-AF-01 <br />