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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: John P.Ary <br /> Permittee Company: Fremont Paving&Redi-Mix, <br /> Inc. <br /> Address: P.O. Box 841 <br /> Canon City, CO 81215 <br /> Phone Number: (719)275-3264 <br /> Fax Number: (719)275-8897 <br /> Email Address: Jp@arycorp.com <br /> Permitting Contact: Jodi Schreiber <br /> Company: Vn p <br /> '�1V1*bAAL -1 V i (W L <br /> Address: <br /> �,h01r1 � <br /> Phone Number: 719 529-0916 <br /> Fax Number: , 119 —&-i s- $B 9-1 <br /> Email Address: Jodi@arycorp.com <br /> Inspection Contact: Jodi Schreiber <br /> Company: a erna , <br /> Address: 1.18;-4148iu 4L <br /> Phone Number: (719)529-0916 <br /> Fax Number: - <br /> Email Address: Jodi@arycorp.com <br /> I,the undersigned ereby state that the information provided in this report is true and accurate, and that site operations are <br /> be co d i ccordance ith the Division approved mining and reclamation plans. <br /> 41 bil <br /> 7 <br /> Sign t re er ee or ate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br /> l <br />