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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: Albert F.Nesselhuf,Jr. <br /> Permittee Company: William& Beverly Caldwell and <br /> Albert& Lola Nesselhuf <br /> Address: 31738 County Road 13 <br /> Manzanola, CO 81058 <br /> Phone Number: (719)462-5236 <br /> Fax Number: <br /> Email Address: Enesselhuf a;rural-com.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 Desit4nee Date <br /> M-AF-01 <br />