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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: Edward L. Suppes <br /> Permittee Company: The Uncompahgre Valley Water <br /> Users Association <br /> Address: 601 N. Park Ave <br /> Montrose, CO 81401 <br /> Phone Number: (970)249-3813 <br /> Fax Number: <br /> Email Address: Esuppes@montrose.net <br /> Permitting Contact: Edward L. Suppes <br /> Company: The Uncompahgre Valley Water <br /> Users Association <br /> Address: 601 N. Park Ave <br /> Montrose, CO 81401 <br /> Phone Number: (970)249-3813 <br /> Fax Number: <br /> Email Address: Isuppes@montrose.net <br /> Inspection Contact: Edward L. Suppes <br /> Company: The Uncompahgre Valley Water <br /> Users Association <br /> Address: 601 N. Park Ave <br /> Montrose, CO 81401 <br /> Phone Number: (970)249-3813 <br /> Fax Number: <br /> Email Address: 1psuppes@montrose.net <br /> Q <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 /> Z <br /> Signature of Permittee,Corporate cer,Owner,or Documented Designee Date <br /> M-AF-01 <br />