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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: Rodney E.Due <br /> Permittee Company: Town of Crested Butte <br /> Address: 507 Marroon Ave. <br /> P.O. Box 39 <br /> Crested Butte, CO 81224 <br /> Phone Number: (970)349-5338 <br /> Fax Number: (970)349-6626 <br /> Email Address: <br /> I,the undersigned,h- . state that the information provided in this report is true and accurate,and that site operations are <br /> being conducted ' ► dance with the Division approved mining and reclamation plans. <br /> /1 �� 6/1/ <br /> /14 Z ;7o/ <br /> Signature o Perm'/ee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-04 <br />