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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: Scott Davis <br /> Permittee Company: Schmidt Construction Company <br /> Address: 2635 Delta Dr. <br /> Colorado Springs,CO 80910 <br /> Phone Number: (719)392-4207 <br /> Fax Number: (719)392-4245 <br /> Email Address: Sdavis@schmidtconstr.com <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 /> ILL 4 3 -S-2 <br /> rmttee.Co <br /> % <br /> Signature of Peraorate O ricer,Owner,or Documented Designee Date <br /> M-AF-01 <br />