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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: Ronda Neumeister <br /> Permittee Company: RBK Construction, Inc. <br /> Address: P.O. Box 387 <br /> Rye, CO 81069 <br /> Phone Number: (719)489-3385 <br /> Fax Number: (719)489-2268 <br /> Email Address: <br /> I,the undersign hereby state that the information provided in this report is true and accurate, and that site operations are <br /> being conducted i a ordance with the ivision approved mining and reclamation plans. <br /> /0/7J/6 <br /> Signature of Permi a or ,or e- ffi r,Owner,or Documented Designee Date <br /> M-AF-01 <br />