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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 />JamesS. Miner <br />Permittee Company: <br />Builder's Aggregate, Inc. <br />Address: <br />510 Dahlia St. <br />Fort Morgan, CO80701 <br />Phone Number: <br />(970) 867-6334 <br />Fax Number: <br />(970) 542-0832 <br />Email Address: <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 />i <br />71%14- <br />ature ofPermittee, Corporate Officer, Owner, or Documented Designee 4,-----(P--- <br />AF-01 <br />