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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: Kane Schneider <br /> Permittee Company: Colorado Department of <br /> Transportation <br /> Address: 606 S. 9th St. <br /> Grand Junction, CO 81501 <br /> Phone Number: (970)683-6300 <br /> Fax Number: (970)683-6340 <br /> Email Address: Kane.schneider@dot.state.co.us <br /> Permitting Contact: Rex Goodrich <br /> Company: Colorado Department of <br /> Transportation <br /> Address: 222 S 6th St Rm 317 <br /> Grand Jy�a 'onet�,CO 81501 <br /> jc <br /> Phone Number: (970)2 <br /> Fax Number: <br /> Email Address: <br /> Inspection Contact: Rex Go 1"�eiclr- <br /> Company: Colorado Department of <br /> Transportation <br /> Address: 222 S 6th 317 <br /> G�ud unction, CO 81501 <br /> Phone Number: (970 2 - -- <br /> 1�� 63�� <br /> Fax Number: <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 /> -2d,-� <br /> Signature ot Permittee,Corporate Officer,Owner,or Documented Desilinee Date <br /> M-AF-04 <br />