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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: j Av/CJ MOYI RN °` r e L3 s <br /> Permitting Contact: Jay J , L�1 P J o v <br /> Company: J S C L--�,3 c- <br /> Address: P-O-.Box*K- <br /> Meeker,CO 81641 <br /> YYl��ker, ed 8/6�/ <br /> Phone Number: q/74 - $7 K' J�o�RP- � <br /> Fax Number: q 7(2S - g 7 g'- 5 3 9 .2 ', <br /> Email Address: <br /> Inspection Contact: Boyles <br /> j e1 ✓ <br /> Company: Rio Blanco County <br /> Address: RG-BVx-I£*- 5-70 Se-Co-Aj �-�-, <br /> Meeker,CO 81641 <br /> M ee-1 -er- CC) 8"14 Ll <br /> Phone Number: - <br /> 97 - 2'7,F - 95-90 <br /> Fax Number: ?,7O _ 57$ _ 33 ?6 v <br /> Email Address: � <br /> , u s <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 /> ee or orate Officer,Owner,or Documented Designee Date ignature of Per tt <br /> M-AF-04 <br />