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Page 5 of 5 <br /> Division records indicate the following pennittee contact information. If this information is not current,please type or print <br /> current contact information: <br /> Permittee Contact: Byron Weathers <br /> Permittee Company: Byron J. & LaLani R. Weathers <br /> Address: 11955 CR 37 <br /> Yuma,CO 80759 <br /> Phone Number: (970)848-2912 <br /> Fax Number: <br /> Email Address: Byron@weathersfarms.net <br /> I,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 PeVrnittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AFdii <br />