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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: Don Marr <br /> Permittee Company: Yuma County <br /> Address: 1310 S. Blake St. MAY 3 0 2017 <br /> Wray, CO 80758 <br /> DIVISION OF RECLAMATION, <br /> Phone Number: (970) 332-5718 :PORT <br /> S <br /> Fax Number: (970)332-3429 Pe_ <br /> Email Address: Yumacountyrb@gmail.com <br /> Permitting Contact: Don Marr <br /> Company: Yuma County <br /> Address: 1310 S. Blake St. <br /> Wray, CO 80758 <br /> Phone Number: (970) 332-5718 <br /> Fax Number: (970) 332-3429 <br /> Email Address: Yumacountyrb@gmail.com <br /> Inspection Contact: Don Marr <br /> Company: Yuma County <br /> Address: 1310 S. Blake St. <br /> Wray,CO 80758 <br /> Phone Number: (970) 332-5718 <br /> Fax Number: (970) 332-3429 <br /> Email Address: Yumacountyrb@gmail.com <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 /> Signature of P mittee,Corporate Officer,Owner,or Documented Desiznee Date <br /> M-\F-Oa <br /> � .. C9g /• l '1 97 <br />