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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: Daryl R. Webster <br /> Permittee Company: Webster Sand&Gravel,LLC <br /> Address: P.O. Box 1834 <br /> Colleyville,TX 76034-1834 <br /> Phone Number: (719)486-0427 <br /> Fax Number: (719)486-0427 <br /> Email Address: Dwebsters3@yahoo.com <br /> Permitting Contact: -etrm les-Webster <br /> 1 W <br /> Company: Webster Sand&Gravel ` <br /> Address: <br /> Cz <br /> 7h0 3 C/ <br /> Phone Number: (719)486-0427 <br /> Fax Number: <br /> '7((�) -0 2 <br /> Email Address: W1 ` <br /> C �OP YeAkOZ)tC-&--- <br /> Inspection Contact: 1 <br /> ►� �r D ura.`y�,n5 <br /> Company: Webster Sand&Gravel/G <br /> Address: P.O. Box 1535 ky t2 l <br /> Leadville, CO 80461N <br /> -Z s4a, le-* <br /> Phone Number: (719)486-0427 <br /> Fax Number: , -496 <br /> 37-3C7 <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 accordance with the Division approved mining and reclamation plans. <br /> 7 P—�Z'6�"--,r--� �i <br /> Sign re ermittee,Coryo ate Officer.Owner,or Documented Designee Date <br /> M-AF-01 <br />