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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: Jason Burkey <br /> Permittee Company: Oldcastle SW Group, Inc. dba <br /> United Companies of Mesa <br /> County <br /> Address: P.O. Box 3609 <br /> Grand Junction, CO 81502- <br /> 3609 <br /> Phone Number: (970)243-4900 <br /> Fax Number: (970)243-5945 <br /> Email Address: Jburkey@oldcastlematerials.com <br /> Permitting Contact: Greg Lewicki <br /> Company: Greg Lewicki and Associates <br /> Address: 11541 Warrington Court <br /> Parker, CO 80138 <br /> Phone Number: (303)346-5196 <br /> Fax Number: <br /> Email Address: <br /> Inspection Contact: Ju '�� <br /> Company: Oldcastle SW Group, Inc. dba <br /> United Companies of Mesa <br /> Count <br /> Address: P.O. Box 3609 <br /> Grand Junction, CO 81502 <br /> Phone Number: (970)243-4900 <br /> Fax Number: <br /> Email Address: <br /> 1,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 /> / ' 17 <br /> Signature of Permittee Coro to Officer, ner,or Documented Desienee Date <br /> M-AF-01 <br />