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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 />TQffYeVMftT <br />DtkS-hn -D(- <br />LZ <br />Permittee Company: <br />DeWitt Excavating, Inc. <br />Address: <br />zl----> <br />7395 U.S <br />Lamar, 1052 <br />q h Y ro <br />nv�,. <br />Phe Number: <br />Ip <br />(719) 336-4455 <br />�ax Number: <br />(719) 336-8150 <br />Email Address: <br />etlj r q+e* <br />I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are <br />being con ucted 7*1,with the Division ap roved mining and reclamation plans. <br />�1 <br />Signature ofPermittee Cor orate fficer, Own e , or Documented Desijnee Date <br />M -AF -01 <br />C'�f-CL8QXr �ar� I <br />