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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: Connie N. Davis <br />Permittee Company: Aggregate Industries - WCR, <br />Inc. <br />Address: 1687 Cole Blvd., Ste. 300 <br />Golden, CO 80401 <br />Phone Number: 970) 396-5252 <br />Fax Number: 303) 716-5295 <br />Email Address: Connie.davis@aggregate-us.com <br />Permitting Contact: Danna Ortiz Connie N. Davis <br />Company: Rocky Mountain Consultants, <br />Inc. <br />Aggregate Industries-WCR, Inc. <br />Address: 825 Delaware Ave, Ste 500 <br />Longmont, CO 80501 <br />1667 Cole Blvd., Suite 300 <br />Golden, CO 80401 <br />Phone Number: 303) 985-1070 970) 396-5252 <br />Fax Number: <br />303) 716-5295 <br />Email Address: connie.davis@aggregate-us.com <br />Inspection Contact: Michael C. Refer Connie N. Davis <br />Company: Aggregate industries - WCR, <br />Inc. <br />Address: 1687 Cole Boulevard, Suite 300 <br />Golden, CO 80401-3220 <br />Phone Number: 303) 985-1070 <br />Fax Number: 303) 716-5299 <br />Email Address: connie.davis@aggregate-us.com <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 />Signature of Permittee, Corporate Officer, Owner, or Documented Desianee Date <br />u A- r. _.