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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: Kevin Anderson <br /> Permittee Company: Connell Resources, Inc. <br /> Address: 7785 Highland Meadows Pkwy. <br /> Ste 100 <br /> Fort Collins,CO 80528 <br /> Phone Number: (970)223-3151 <br /> Fax Number: a 7d ? 2 3- /q q ►7b <br /> Email Address: <br /> Gl k C r S o .. e o^-e lli'es',o •cd" <br /> Permitting Contact: Bill Schenderlein <br /> Company: Blue Earth Solutions, LLC <br /> Address: PO Box 2427 <br /> Fort Collins,CO 80522 <br /> Phone Number: gMlsr ?70 -�Z Z 7 _ 2 SO 63 <br /> Fax Number: <br /> Email Address: ,6•'/�Q6�ueC�rfL SD� 7L;a x <br /> Inspection Contact: Kevin Anderson <br /> Company: Connell Resources, Inc. <br /> Address: 7785 Highland Meadows Pkwy., <br /> Ste. 100 <br /> Fort Collins,CO 80528-5000 <br /> Phone Number: (970)223-3151 <br /> Fax Number: (970)223-3191 <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 with the Division approved mining and reclamation plans. <br /> 12 <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />