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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: David P.Morlan <br /> Permittee Company: Rio Blanco County <br /> Address: 570 2nd St. <br /> Meeker, CO 81641 <br /> Phone Number: (970) 878-9590 <br /> Fax Number: (970) 878-3396 <br /> Email Address: Dave.morlan@rbc.us <br /> Permitting Contact: Stanley Rasmussen <br /> Company: Rio Blanco County <br /> Address: 17497 Hwy. 64 <br /> Rangely, CO 81648 <br /> Phone Number: - 970 - &7 F— cl 5-?g <br /> Fax Number: - 4 70 - $.w ?lo ye47 <br /> Email Address: <br /> Inspection Contact: Stanley Rasmussen <br /> Company: Rio Blanco County <br /> Address: 17497 Hwy. 64 <br /> Rangely, CO 81648 <br /> Phone Number: (9:70)675 - C�70 . ?,7 a— S?6- <br /> Fax Number: <br /> 40 7S- <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 Divi ' approved mining and reclamation plans. <br /> natur of Permittee C r o to Officer, Owner,or Documented Designee Date <br /> M-AF-04 <br />