Laserfiche WebLink
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: Cathleen Van Egmond <br /> Permittee Company: Russell Van Egmond <br /> Address: 546 Doe Valley Rd. <br /> Guffey, CO 80820 <br /> Phone Number: 719-689-0877 <br /> Fax Number: 719-689-5889 <br /> Email Address: cathleenmore@aol.com <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 /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />