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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: Dennis Sanchez <br /> Permittee Company: Colorado Department of <br /> Transportation <br /> Address: 260 Ranney St. <br /> Craig, CO 81625 <br /> Phone Number: (970)824-5104 1-70 10Ct <br /> Fax Number: (970)826-5213 <br /> Email Address: Dennis.sanchez@state.co.us <br /> Permitting Contact: Rex Goodrich <br /> vtvuS �kJ� Z <br /> Company: Colorado Department of <br /> Transportation <br /> Address: 222 S 6th St Rm 317 <br /> Grand Junction, CO 81501 Li, ( ' Cc C1 <br /> Phone Number: 970 248-7228 <br /> Fax Number: <br /> Email Address: t <br /> Inspection Contact: Rex Goodrich <br /> Company: Colorado Department of <br /> Transportation <br /> Address: 222 S 6th St Rm 317 <br /> Grand Junction, CO 81501 � � <br /> Phone Number: (970)248-7228 L\I Tr) , <br /> Fax Number: �7C &L b <br /> Email Address: I_ I <br /> I,the((��ndersigned, hereby state that the information provided in this report is true and accurate, and that site operations are <br /> being riducted in acc dance with the Division approved mining and reclamation plans. <br /> ADZ i-5f : 17 <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-04 <br />