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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: Connie N.Davis <br /> Permittee Company: Aggregate Industries-WCR, <br /> Inc. <br /> Address: 1687 Cole Blvd., Ste. 300 <br /> Golden,CO 80401 <br /> Phone Number: (970)396-5252 <br /> Fax Number: (303)716-5295 <br /> Email Address: Connie.davis@aggregate-us.com <br /> Permitting Contact: Patrick Ward <br /> Same as Permittee <br /> Company: Aggregate Industries-WCR, <br /> Inc. <br /> Address: 1707 Cole Blvd., Ste. 100 <br /> Golden,CO 80401-3220 Same as Permittee <br /> Phone Number: (303)985-1070 <br /> Same as Permittee <br /> Fax Number: <br /> Same as Permittee <br /> Email Address: <br /> Same as Permittee <br /> Inspection Contact: Patrick Ward <br /> Same as Permittee <br /> Company: Aggregate Industries-WCR, <br /> Inc. <br /> Address: 1707 Cole Blvd., Ste. 100 <br /> Golden,CO 80401-3220 <br /> Same as Permittee <br /> Phone Number: (303)985-1070 <br /> Same as Permittee <br /> Fax Number: <br /> Same as Permittee <br /> Email Address: <br /> Same as Permittee <br /> I,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 /> zw.acr � 6"�-, is Z'l <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 ------- <br />