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Page 5 of 5 <br /> Division records indicate the following permittee/landowner contact information(blank fields indicate that we do not have <br /> information on record). If this information is blank or not current,please type or print current contact information: <br /> Permittee Contact: James Cooley <br /> Permittee Company: J and K Limestone Products, <br /> LLC _ <br /> Address: 4469 N CR 108 <br /> Mosca, CO 81146 <br /> Phone Number: (719)378-253OX 7 C j�jcaS <br /> Fax Number: 7 <br /> 1 91rasC <br /> Email Address: Cooleyandsons@gmail.com <br /> Permitting Contact: James Cooley <br /> Company: J and K Limestone <br /> Products,LLC <br /> Address: 4469 N CR 108 <br /> Mosca,CO 81146 <br /> Phone Number: (719)378-2352 <br /> Fax Number: <br /> Email Address: C Och�C?t✓ CZii�SO"SC_144 <br /> Inspection Contact: James Cooley <br /> Company: J and K Limestone <br /> Products,LLC <br /> Address: 4469 N CR 108 <br /> Mosca, CO 81146 <br /> Phone Number: (719)378-2352 <br /> Fax Number: h -�/ C?_ 1,? CS, <br /> Email Address: ' <br /> I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations arc <br /> being conducted in accordance with the Division approved mining and reclamation plans. <br /> Signature oWermittee,Corporate Off r,Owner,or Documented Designee Date <br /> WAF-- <br />