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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: Bob Solberg <br /> Permittee Company: Solberg Gravel LLC <br /> Address: 13745 Garrett Rd <br /> Peyton, CO 80831 <br /> Phone Number: (719) 683-3198 <br /> Fax Number: (719) 683-437 3 <br /> Email Address: <br /> I, the undersigned, hereby state that the information provided in'this report is true and accurate, and that site operations are <br /> being con ucted in accordance vbith the Division approved mining and reclamation plans. <br /> ALI <br /> Sign re of Perin e,CoOrporate Officer, Owner,or Documented DesiLmee Date <br />