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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: Greg Norwick n, <br /> Permittee Company: Everist Materials,LLC <br /> Address: P.O.Box 1150 <br /> 28755 Highway 9 <br /> Silverthorne,CO 80498 <br /> Phone Number: (970)468-2521 <br /> Fax Number: 2 '7 S 6o <br /> Email Address: e f^4- <br /> 1,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 /> eT,3 L" t, I <br /> Signature ot Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />