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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: George E. Often <br /> Permittee Company: Central City Consolidated Mng <br /> Address: C/o Hunter Gold Mining Corp <br /> 11438 Weld County Rd.l9 <br /> Fort Lupton, CO 80621 <br /> Phone Number: (970)785-2538 <br /> Fax Number: (970)785-6248 <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 /> j� I �- 0/6 <br /> Signa e o Permittee, Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-02 <br />