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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: Swhite@montrosecounty.net <br /> Permitting Contact: 'Daffiy-Lencar" I <br /> Company: Montrose County <br /> Address: 949 N 2nd Street <br /> Montrose, CO 81401 <br /> Phone Number: ( - <br /> cllz- <br /> Fax Number: <br /> Email Address: I4ee coup net�s,1�e�ose ty. <br /> Inspection Contact: 9Wrrp-1✓enear- J <br /> Company: Montrose County <br /> Address: 949 N 2nd Street <br /> Montrose, CO 81401 <br /> Phone Number: f - <br /> Fax Number: <br /> Email Address: et- <br /> /bt J\AV"i IN <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 /> /�LAN/J//✓L. S VOL', ;01(2. 10 —G-17 <br /> Si ature of ermittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-04 <br />