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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 />Skylar Carpenter <br />Permittee Company: <br />Grand Gravel Pit, LLC <br />Address: <br />2 County Road 2 <br />Kremmling, Co 80459 <br />Phone Number: <br />(970) 531-2327 <br />Fax Number: <br />Email Address: <br />M (21 \(a L -to- <br />Q_Gmni.\.Wrv1 <br />•� ym i.com cP ct <br />\o Vu� LSC(10s <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 />Signature i'i Permittee, Corporate Officer, Owner, or Documented Designee Date <br />M -AF -01 <br />