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Page 5 of 5 <br /> Division records indicate the following permittee contact information. If this information is not current,please type or print <br /> current contact information: <br /> Permittee Contact: Judy Sprague <br /> Permittee Company: ARKINS PARK STONE <br /> CORPORATION <br /> Address: 5975 NCR 27 <br /> Loveland, CO 80538 <br /> Phone Number: (970)663-1920 <br /> Fax Number: (970)663-2315 <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 /> bein on u ed in accordance with the Division approved mining and reclamation plans. <br /> S1.9, � //�— <br /> ignatur of Permitte orate Officer,Owner,or Documented Designee ate <br /> -AF-OI <br />