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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: David Morlan <br /> Permittee Company: Rio Blanco County <br /> Address: 570 2nd St. <br /> Meeker,CO 81641 <br /> Phone Number: (970)878-9590 <br /> Fax Number: (970)878-3396 <br /> Email Address: David.morlan@rbc.us <br /> Permitting Contact: iftmess W.4@y <br /> Company: y <br /> Rio ca <br /> Address: P.9. Box 1153 676 Seco,uc� Street <br /> Meeker,CO 81641 <br /> 1'1'leekc,r, Co Sl(-q/ <br /> Phone Number: ego)878-5292 Q?Q _ g-7g _ 9�5-?6 / <br /> Fax Number: ct 71!S - $`79 3 3 g(o <br /> Email Address: Ctyj e I t@ V-6c. 0 S <br /> Inspection Contact: 13ayti-me�Iam <br /> Company: Rio Blanco County <br /> Address: 42.0. 11Q*vrr r�� s e.Gb JV 8 S+re—'e+ / <br /> Meeker,CO 81641 m e e ke n C-a ?�hL <br /> Phone Number: (799)8:7$ 9 70 — 97.7 2(, g F?O 1/ <br /> Fax Number: () 7 d _ g 7 Ss'_ 3 3 <br /> Email Address: <br /> c.I C-4 lqppedf@r6c. L) S <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 /> gnature of Permittoge.Odryorate Officer,Owner,or Documented Desienee Date <br /> M-AF-04 <br />