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PaW3d3 <br />Tl'.' ' n...3n :...T....,rd fS.o � ll.,,..'.... :tsz��A�..�... ♦n..s " fn.aH..e',..., Ill 1- F���.ln : .T. to sl...* an r S,n..e <br />vi:i�iases •�w.aaw ■ausN.�aran,: sss •venawea.� �i..0 .�asa.:swi wais�aa ueeaw�trsc.sria yv�s <br />information on record). if this information is blank or not current, Tease type or print contact infer <br />T------ - - <br />ti'"PCrrt4rCn5C .MW==- TMAEar-44� <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 witl� the Division approved mining and reclamation plans. <br />Signature o Permittee Corporate Officer, Owner, or Documented Desi nee Date <br />N1 AF J <br />Address: <br />P.O. Box456 <br />Ridgway, CO 81432 <br />Phone Number: <br />(970) 626-5391 <br />Fax Number: <br />(970) 6264439 <br />Email Address: <br />Scalkins@ouraycountyco.gov <br />ouraycountyco.gov <br />Permitting Contact: <br />Chris Miller C- <br />Na cr wcrK.s Gr ( <br />c <br />�CUC/� ckjy-n.'� <br />Company: <br />Ouray County <br />Address: <br />P.O. Box 456 <br />Ridgway, CO 81432 <br />Phone Number: <br />(970) 626-5391 <br />Fax Number: <br />Email Address: <br />Inspection Contact: <br />Chris Miller <br />G SZOef ter f;or Coo,StaiU1 <br />1�1 nS <br />Company: <br />Ouray County <br />Address: <br />P.O. Box 456 <br />Ridgway, CO 81432 <br />Phone Number: <br />(970) 626-5391 <br />Fax Number: <br />(970) 6264439 <br />Email Address: <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 witl� the Division approved mining and reclamation plans. <br />Signature o Permittee Corporate Officer, Owner, or Documented Desi nee Date <br />N1 AF J <br />