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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: David P.Morlan <br /> Permittee Company: Rio Blanco County <br /> Address: 570 2nd St. <br /> Meeker,CO 81641 <br /> Phone Number: (970)878-9590 <br /> Fax Number: (970)878-3396 <br /> Email Address: David.morlan@rbc.us <br /> Permitting Contact: Stanley Rasmussen <br /> Company: Rio Blanco County ✓ <br /> i �14 CO co v�3 <br /> Address: 17497 Hwy. 64 <br /> LS <br /> Rangely, CO 81648 `��d S�-CD"N <br /> M'z-e.ke.'r, c,L s-/ �0 Ll 1 <br /> Phone Number: (970)675-8644 9 76 " 3 78. 9 5'q d <br /> Fax Number: (970)675-5211 <br /> 3 3910 <br /> Email Address: <br /> Cl1Il? r U <br /> Inspection Contact: Stanley Rasmussen <br /> c <br /> Company: Rio Blanco County � <br /> CC 8 1g e o <br /> Address: 17497 Hwy. 64 S'T� SeG�N a Sfi <br /> Rangely, CO 81648 <br /> (A kern Ca 'r/4,Y <br /> Phone Number: (970)675-8644 <br /> 4?6 , 379' 45-c�o � <br /> Fax Number: (970)675-5211 <br /> 0 - 9725- 339 <br /> Email Address: <br /> c.1 iNt. <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 /> Sig ure ot Permittee,C aorate Officer,Owner,or Documented Desienee Date <br /> M-AF-04 <br />