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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: Steve White <br /> Permittee Company: Montrose County <br /> Address: 949 N. 2nd Street <br /> Montrose, CO 81401 <br /> Phone Number: (970)249-6688 <br /> Fax Number: <br /> Email Address: <br /> Permitting Contact: .E44t-:.'-ineller- <br /> Company: Montrose County <br /> Address: Montrose County <br /> 'Montrose, CO 81401 <br /> Phone Number: <br /> Fax Number: �` v <br /> Email Address: <br /> tL�NiT� mvh'T�sE c��t�JRl <br /> Inspection Contact: nnth3t�olaerts <br /> L rr� <br /> Company: Montrose County <br /> Address: 32 S First S <br /> P.O. Bo 89 > /�/ ��✓u'A S T,z��r <br /> Jontfo'se, CO 81402 <br /> /1'l Tier. nit <br /> Phone Number: (970)249-6688 <br /> Fax Number: a Lt <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 /> //// 1 <br /> 26V Sign re of Permittee,Corporat Officer,Owner,or Documented Designee Date <br /> M-AF-04 <br />