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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: <br />Scott Davis <br />Permittee Company: <br />Schmidt Construction Company <br />Address: <br />2635 Delta Dr. <br />Colorado Springs , CO 80910 <br />Phone Number <br />(719) 392-4207 <br />Fax Number: <br />(719) 392-4245 <br />Email Address: <br />SDAVIS@scbmidtconstr.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 ducted in accordance with the Division approved mining and reclamation plans. <br />Afui .v.A <br />Signature of Permittee, Corporate Officer, Owner, or Documented Designee <br />M -AF -0I <br />- <br />Date <br />