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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: Steve White <br /> Permittee Company: Montrose County <br /> Address: 949 N. 2nd Street <br /> Montrose, CO 81401 <br /> Phone Number: (970)252-4550 <br /> Fax Number: <br /> Email Address: <br /> Permitting Contact: Ben+agen€t4� <br /> -re <br /> Company: <br /> -7 <br /> t 1 k T-"2 <br /> Address: arrin <br /> Phone Number: +2 s,24--_ <br /> Fax Number: (.303)346- 4-24— <br /> Email Address: <br /> Inspection Contact: 'iistm- <br /> Company: Montrose County <br /> Address: 161 South Townsend Avenue r , <br /> Montrose, CO 81401 Cf <br /> � r <br /> Phone Number: (970)252-7000 <br /> Fax Number: (970)252-7010 <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 ' t Division approved mining and reclamation plans. <br /> �/'/ D 7 ZZ/ <br /> Signa4re\WPermittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-04 <br />