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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: Nick Michael <br /> Permittee Company: Union Milling Company,LLC <br /> Address: P.O. Box 620490 <br /> Littleton,CO 80162-0490 <br /> Phone Number: (303)947-3499 <br /> Fax Number: <br /> Email Address: Nmichael@unionmilling.com <br /> 1,the undersi ed hereby state that the information provided in this report is true and accurate,and that site operations are <br /> bein n ucted in ance with t ivision approved mining and reclamation plans. <br /> Signature of Permittee.Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-02 <br />