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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: David P.Morlan <br /> Permittee Company: Rio Blanco County <br /> Address: 570 2nd St. <br /> Meeker, CO 81641 <br /> Phone Number: (970) 878-9590 <br /> Fax Number: (970)878-3396 <br /> Email Address: David.morlan@rbc.us <br /> Permitting Contact: �affi -Je3Y Lam; J per/ <br /> Company: Joy Surveying Company J S C - � <br /> Address: 646 Main St <br /> P.O. Box 1153 <br /> Meeker, CO 81641 <br /> Phone Number: (970)878-5292 <br /> Fax Number: <br /> Email Address: <br /> Inspection Contact: e1��� � / � l ✓ <br /> Company: Rio Blanco County �•Y\ <br /> Address: P.�-I <br /> 570 2nd St. <br /> Meeker,CO 81641 <br /> Phone Number: q 74 _g'7(�- 9 S q0 <br /> v <br /> Fax Number: <br /> 970 - 2;79'_339� ✓ <br /> Email Address: <br /> clire�- c-hri e( IG r6c . uS <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---- I-Ul-f <br /> gnature of Permittee orate Officer,Owner,or Documented Designee Date <br /> M-AF-04 <br />