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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: Bruce E.Neil <br /> Permittee Company: Neil's Excavation <br /> Address: 486 CR 515 <br /> Ignacio, CO 81137 <br /> Phone Number: (970)884-2290 <br /> Fax Number: (970)884-1000 <br /> Email Address: Neils.excavation@gmail.com <br /> Permitting Contact: Bruce Neil <br /> Company: Neil's Excavation <br /> Address: 486 CR 515 <br /> Ignacio, CO 81137 <br /> Phone Number: (970)884-2290 <br /> Fax Number: <br /> Email Address: <br /> Inspection Contact: Bruce Neil <br /> Company: Neil's Excavation <br /> Address: 486 CR 515 <br /> Ignacio, CO 81137 <br /> Phone Number: (970)884-2290 <br /> Fax Number: 9 7 c g g -• e v'J <br /> d/ <br /> Email Address: 4e1,/s: C-KCiAv�+��K <br /> 1,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 /> �,- /,�z/- to /o /7 <br /> Sig at a of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />