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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: 'I7mr-Qts <br /> Company: Montrose County <br /> Address: P.O. Box 1289- 949 <br /> MnO 81402 <br /> Phone Number: (3(>249:,6688 <br /> Fax Number: <br /> 176' — -1 C) <br /> Email Address: <br /> Inspection Contact: Ti th erts <br /> Company: Montrose County <br /> Address: Bo <br /> P. w Y2g9 9 ,1 Aft �` <br /> oet , CO 81402 A) `� <br /> Phone Number: (303) -6-6688 <br /> - 3 a..r? <br /> Fax Number: w f s� <br /> 9 /7G fS fJ - 7 f i <br /> Email Address: /� <br /> I,the undersigned,hereby state at the information provided in this report is true and accurate, and that site operations are <br /> being conducted accordanc: k the Division approved mining and reclamation plans. <br /> Signa re o Pe ittee, i r i i •to Officer,Owner,or Documented Designee D e <br /> M-AF-04 <br />