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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: Foster G. Scott <br /> Permittee Company: The Turquoise Connection, Inc. <br /> Address: 107 Wild Rose Dr. <br /> Canon City, CO 81212 <br /> Phone Number: (719) 557-2846 <br /> Fax Number: <br /> Email Address: Fscott705@aol.com <br /> Permitting Contact: Foster G. Scott <br /> Company: The Turquoise Connection, Inc. <br /> Address: 107 Wild Rose Dr. <br /> Canon City, CO 81212 <br /> Phone Number: (719) 557-2846 <br /> Fax Number: <br /> Email Address: Fscott705@aol.com <br /> Inspection Contact: Foster G. Scott <br /> Company: The Turquoise Connection, Inc. <br /> Address: 107 Wild Rose Dr. <br /> Canon City, CO 81212 <br /> Phone Number: (719) 557-2846 <br /> Fax Number: <br /> Email Address: Fscott705@aol.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 /> C/-��> '2� Z/�!� ' - Z,� - /� <br /> Signature ofPermittee, Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />