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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: Tim Mahoney <br /> Permittee Company: Skanska USA Civil West Rocky <br /> Mountain District Inc. <br /> Address: 1995 Agua Mansa Road <br /> Riverside, CA 92509 <br /> Phone Number: (970)684-5360 <br /> Fax Number: (970)368-6463 <br /> Email Address: Tim.mahoney@skanska.com <br /> Permitting Contact: Craig Wickstrom <br /> Company: Skanska USA Civil West Rocky <br /> Mountain District Inc. <br /> Address: 22419 CR G <br /> P.O. Box 1660 <br /> Cortez, CO 81321 <br /> Phone Number: (970)565-8000 <br /> Fax Number: <br /> Email Address: <br /> Inspection Contact: Craig Wickstrom <br /> Company: Skanska USA Civil West Rocky <br /> Mountain District Inc. <br /> Address: 22419 CR G <br /> P.O. Box 1660 <br /> Cortez,CO 81321 <br /> Phone Number: (970)565-8000 <br /> Fax Number: <br /> Email Address: <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 /> "�L-7.-. Z-'�F'4 t/, -5--/ 2 <br /> Signature of Permittee or orate Office wner,or Documented Designee Date <br /> M-AF-01 <br />