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Page 5 of 5 <br /> Division records indicate the following permittee/landoH ner contact information(blank fields indicate that we do not ha),e <br /> information on record). If this information is blank or not current,please h pe or print current contact information: <br /> Permiltee Contact: <br /> Andre Laroche <br /> Permrttee Company: Continental Materials <br /> _ Corporation <br /> Address: 444 E.Costilla St. <br /> Colorado Springs,CO 80903 <br /> I <br /> Phone Number. (719) 491-0288 <br /> Fax Numlx r: (:74 9)398 3853 <br /> Email Address: Andre_larochenatransitmix.com <br /> Permitting Contact: Andre Laroche <br /> Company: Continental Materials Corp dba <br /> Transit Mix Concrete Co. <br /> Address: 444 E.Costilla <br /> Colorado Springs,CO 80903 <br /> Phone Number (719) 491-0288 <br /> Fax Number: <br /> Email Address: andre—laroche@?transitinix.com <br /> Inspection Contact: Andre Laroche <br /> Company: Continental Materials Corp dba <br /> Transit Mix Aggregates <br /> Address: 444 E.Costilla <br /> Colorado,CO 80903 <br /> Phone Number: (719) 491-0288 <br /> Fax Number: <br /> Email Address: andre lroche q'Aransit llix.coin <br /> I,the undersigned,hereby state that the information provided in this report is true and accurate,and that site operations are <br /> being c cted in accordapFe Keith r Di ision approved trim,and reclamation plans. <br /> "�zlu 05-18-2017 <br /> Sign re or ermittce Cor orate Officer,Owner,or Documented Designee Date <br /> A9 4h <br /> 41Page <br />