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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 print <br /> current contact information: <br /> Permittee Contact: Thomas S. Hendricks <br /> Permittee Company: Calais Resources Colorado,Inc. <br /> Address: P.O. Box 653 <br /> Nederland, CO 80466-0653 <br /> Phone Number: (303)258-3953 1-- <br /> -0 <br /> Fax Number: 8 8 NO <br /> N 6 M bE P- RT l'kV? T )M <br /> Email Address: <br /> I,thejcducted <br /> gned,here state that the information provided in this report is true and accurate, and that site operations are <br /> bein in acc anLwiththe Division approved mining and reclamation plans. <br /> 11 - 6 <br /> Sig ature of Permittee or or to Officer,Owner,or Documented Designee hate <br /> M-AF-02 <br />