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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 />Bernard R. Buster <br />Permittee Company: <br />ELB Stone, Inc. <br />Address: <br />2493 CR 37 E <br />Lyons, CO 80540 <br />Phone Number: <br />(303) 823-5659 <br />Fax Number: <br />(303) 823-0173 <br />Email Address: <br />SI6necoat, <br />ar6 ono <br />s/,- 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 in accordance with the Division approved mining and reclamation plans. <br />.t&Jw-e,erYQ,,e.e..,e. <br />Signature of Permittee, Corporate Officer, Owner, or Documented Designee Date <br />M -AF -01 <br />