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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: Gregory E.GulleyI L/ <br /> Permittee Company: Denver Water Department <br /> ).e.nvQr t,.Jerre PepAP.-1MENS <br /> Address: 1600 W. 12th Ave. boo �, -Z-w- �,y M k oL Co c E 1-ill <br /> Denver,CO 80204 D e N vie- Co g° 7---° ‘1 <br /> t <br /> Phone Number: (303)628-6398 <br /> (303 GZF- 65 39 <br /> Fax Number: (303)628-6309 (3 0 3) G7-- ' — , 5-Z <br /> Email Address: Greg.gulley@denverwater.org Cyon S44+9_ J 0.3-tr..ta l-cr_0--r-, <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/• accord e 'th the Division approved mining and reclamation plans. <br /> ,zfiLlIC. <br /> Signature of Per itt• Corporat 4cer,Owner,or Documented Designee Date <br /> M-AF-01 <br />