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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: Rick Hunt <br /> Permittee Company: Rick L Hunt <br /> Address: 43160 County Rd 17-21 <br /> Elizabeth,CO 80107 e5-Y i>W'"*2 O&Y <br /> Phone Number: (303)646-6486 3 o 3 - -7 73_/p0 <br /> Fax Number: (303)646-9233 30 _ -7-/ 3 _ <br /> Email Address: <br /> �o$�,6n9B/,i <br /> 1,the undersign state that the information provided in this report is true and accurate,*and that site operations are <br /> being cgn cted in acco ith the Division approved mining and reclamation plans. * 1-21 Th,� �fJT <br /> Signatur of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />