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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: Daniel DiRezza <br /> Permittee Company: Direzza Limited Family <br /> Partnership <br /> Address: 4815 Hwy 194 <br /> Las Animas,CO 81054-9411 <br /> Phone Number: (719)469-5511 <br /> Fax Number: <br /> Email Address: Ddirezza@gmail.com <br /> Permitting Contact: <br /> Company: Dave Direzza <br /> Address: 33155 E H 4 <br /> La a,CO 81050 <br /> Av�� //Is AAjj'1q,1E Cc, <br /> Phone Number: (719 3 <br /> Fax Number: <br /> Email Address: ` <br /> ►^ Z ec6) 2d'(TO <br /> Inspection Contact: Dan DiRezza <br /> Company: Direzza Limited Family <br /> Partnership <br /> Address: 33155 E H ✓Z41 <br /> L ,CO 81050 <br /> KI5 )/,j r �� <br /> Phone Number: <br /> l 2� ���� <br /> Fax Number: <br /> Email Address: <br /> I,the undersigne , ereby state that the informguon provided in this report is true and accurate, and that site operations are <br /> being condu d in ccordance w' Di ' ion pprov wing and reclamation plans. <br /> Signature of Permittee Cor ,or O er,Owner,or Documented Designee Date <br /> M-AF-01 <br />