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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: Ssott cevixi2n Jerry Nettleton <br /> Permittee Company: Peabody Sage Creek Mining, <br /> LLC <br /> Address: k8 Dex--SSA 29515 RCR27 <br /> 36689-Reutt4;� 4-2-71 Oak Creek, Colorado 80467 <br /> I Ia���-�-I825-8Ls9 <br /> Phone Number: (9744 276 7003 970.870.2712 <br /> Fax Number: <br /> Email Address: ]nett eton pea o yenergy.com <br /> I,the undersigned,hereby stat that the information provided in this report is true and accurate,and that site operations are <br /> being conducted in a e with the Division approved mining and reclamation plans. <br /> G7.tlr'le <br /> Signa ure of P rnittee4t orate er caner,or Documented Designee Date <br /> M AF-01 <br />