Laserfiche WebLink
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: Mathew L. Valdez <br /> Permittee Company: Costilla County <br /> Address: P.O. Box 130 <br /> San Luis,CO 81152 <br /> Phone Number: (719)672-9109 <br /> Fax Number: (719)672-3003 <br /> Email Address:Address: Mathew.valdez@costillacounty- <br /> co.gov CtiNS. o�ci e 1 cou�n -('o• �J <br /> Permitting Contact: Mathew Valdez (� <br /> (1 <br /> Company: Costilla County <br /> Address: 352 Main St. <br /> San Luis, CO 81152 <br /> Phone Number: (719)672-9109 <br /> Fax Number: (719)672-3003 °t3q_ jq)- <br /> Email Address: Mathew.valdez@costillacounty-o.gov Cltir &, a C�t�4((4C -Cb o✓ <br /> Inspection Contact: Matthew Valdez _ <br /> S� <br /> Company: Costilla County <br /> Address: 352 Main St. <br /> San Luis, CO 81152 <br /> Phone Number: (719)672-9109 ct C,2� <br /> Ca <br /> Fax Number: (719)672-3003 goo) Cc Lf <br /> _ 1> <br /> 3 Z <br /> Email Address: Mathew.valdez@costillacounty- <br /> co.gov C\•ri .row+f' <br /> 1,the undersigned,hereby state that the information provided in this report is true and accurate, and that site operations are <br /> being conduc in accordance with the Division approved mining and reclamation plans. <br /> 1,, (Zlq//7 <br /> Signature of Permittee Corporate ,Owner,or Documented Designee Date <br /> M-AF-04 <br />