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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: Alan Frantz <br /> Permittee Company: Rough Cut, L.L.C. <br /> Address: 15645 Rd. GG <br /> Rocky Ford.CO 81067 <br /> Phone Number: (719)254-4576 <br /> Fax Number: <br /> Email Address: <br /> Permitting Contact: lea avUano- _ / <br /> Company: Development, Inc. <br /> Address: 236N-Merrill D"rive <br /> Pueblo.-CO 81007 <br /> i <br /> Phone Number: (749-}240-9424- - -- -- <br /> Fax Number: (7-14�583=10768 <br /> Email Address: <br /> Inspection Contact: Jae6aghano <br /> Company: L:J:-Development. Inc. <br /> Address: 2-56 N Merrill Drive - <br /> Pueblo,CO- 81007 <br /> Phone Number: 541 3 <br /> i <br /> Fax Number: (T1"3-0?68 <br /> Email Address: <br /> 1.the undersigned,hereby state that the information provided in this report is true and accurate. and that site operations are <br /> being conducted in accordan e Nvith the Division approved mining and reclamation plans. <br /> -7 //7 <br /> Signature r i ee Cor orate Of cer,Owner,or Documented Designee Da <br /> 11:4F-Ol <br />