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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: Itt <br /> Ue-�T Caa <br /> Permittee Company: Lincoln County <br /> Address: P.O.Box 39 <br /> Hugo,CO 80821 <br /> Phone Number: (719)743-2337 <br /> Fax Number: (719)743-2815 <br /> Email Address: <br /> Permitting Contact: ,iel;R-ro" <br /> Company: Lincoln County <br /> Address: P.O.Box 39 <br /> Hugo,CO 80821 <br /> Phone Number: (719)743-2337 <br /> Fax Number: (719)743-2815 <br /> Email Address: <br /> Inspection Contact: `ichn-BeWitr ��� �►c�`t5 <br /> Company: Lincoln County <br /> Address: P.O.Box 39 <br /> Hugo,CO 80821 <br /> Phone Number: (719)743-2337 <br /> Fax Number: (719)743-2815 <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 /> - 'S- . �2 - 7-/ 7 <br /> S' a e f r-mi ee Corporate Officer,Owner,or Documented Designee Date <br /> -oa <br />