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Page 5 of 5 <br />Division records indicate the following permittee contact information. If this information is not current, please type or <br />print current contact information: <br />Permittee Contact: <br />DarenR. Stone <br />Permittee Company: <br />Daren Stone <br />Address: <br />P.O. Box 1568 <br />Cortez, CO81321 <br />Phone Number: <br />(970) 882-3399 <br />Fax Number: <br />(970) 882-3395 <br />Email Address: <br />Dkstone@outlook.com <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 />M -AF -u i <br />L' 1t <br />Date <br />