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Page S of 5 <br /> Division records indicate the following permitted-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: ' Randal Arredondo <br /> Permittee Company: Saguache County <br /> Address: P.O. Box 476 <br /> Saguache, CO 81149 <br /> Phone Number: (719)655-2554 <br /> Fax Number: (719)655-2543 <br /> Email Address: <br /> rarrt'��t bei r— jc:) ,}ttdC'l1CCi`C4:'l1 �t - (C? , elV <br /> Permitting Contact: Ellen Cox <br /> L��n 9e -a c J / - I f J c.l v yl c <br /> Company: Saguache County <br /> Address: P.O. Box 655 <br /> Saguache, CO 81149 f ! T <br /> G6t�J.,cJ� -ic> Pr) C))1,1C <br /> Phone Number: (719)655-2554 <br /> Fax Number: <br /> 9/ti- - -J 7y 3 <br /> Email Address: /' <br /> L' cjc�IY)c `3 C`; ,5 c1C)Lt'cs1CJrc_c:c"ect 7 .—C ri �,kj <br /> Inspection Contact: Ellen Cox J <br /> c ,ca� - te /fit 'c C��,� 0-7c c) <br /> Company: Saguache County <br /> Address: P.O. Box 655 <br /> Saguache, CO 81149 <br /> C1,v) Hgr <" Pr CSC ,e <br /> Phone Number: (719)655-2554 <br /> Fax Number: <br /> Email Address: <br /> y <br /> I,the undersigned,hereby state that the information provided in this report is true and accurate, and that site operations are <br /> being co'a►cted in . --e dance with the Division approved mining and reclamation plans. <br /> _ lC -<< " /7 <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-04 <br />