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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: Brady Miller <br /> Permittee Company: Miller Family Investments,LLC <br /> Address: 428 N. 2nd Street <br /> La Salle, CO 80645 <br /> Phone Number: (970)396-1687 <br /> Fax Number: (970)284-2096 <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 conducted in accordance with the Division approved mining and reclamation plans. <br /> LIPO r <br /> Signature of Per ee, ' po ite Officer,Owner,or Documented Designee Da e <br /> M-AF-0 1 <br />