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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: Ernest J.Marolf <br /> Permittee Company: Mountain View Enterprises <br /> Limited Liability Co <br /> Address: 650 Mountain View Lane 3 c/X <br /> Norwood, CO 81423 ( C`�( L L v <br /> Phone Number: (970)327-4241 <br /> Fax Number: <br /> Email Address: Emarolf@yahoo.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 withjhe Division approved mining and reclamation plans. <br /> -16 <br /> Signature of Permittee or orate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />