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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: Diana K. Watson <br /> Permittee Company: Diana K. Watson <br /> Address: P.O. Box 1056 <br /> Meeker,CO 81641 <br /> Phone Number: (970)629-0583 <br /> Fax Number: ( - <br /> do a )-a <br /> Email Address: Dwatson5898@gmail.com <br /> Permitting Contact: Diana K. Watson <br /> Company: Diana K.Watson <br /> Address: P.O. Box 1056 <br /> Meeker, CO 81641 <br /> Phone Number: (970) 878-5898 <br /> 70 - 2 4- D '83 <br /> Fax Number: - <br /> a daij <br /> Email Address: <br /> Inspection Contact: Diana K. Watson <br /> Company: Diana K. Watson <br /> Address: P.O. Box 1056 <br /> Meeker,CO 81641 <br /> Phone Number: (970)878-5898 <br /> -G.. <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 /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />