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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: Dustin DeWitt <br /> Permittee Company: DeWitt Excavating,Inc. <br /> Address: 7395 U.S.Hwy. 50 <br /> Lamar,CO 81052 <br /> Phone Number: (719)336-4455 <br /> 00 <br /> Fax Number: (719)336-8150 <br /> Email Address: De xc@h ail.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 /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee hate <br /> M-AF-01 <br /> ® I t <br /> -� I <br /> a' Cuq <br />