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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 /> Perm ittee Contact: Ryan Stitt <br /> Permittee Company: City&County of Denver, Board <br /> of Water Commissioners <br /> Address: 1600 W. 12th Ave. <br /> Denver,CO 80204 <br /> Phone Number: (303)628-6539 <br /> Fax Number: (303)628-6851 <br /> Email Address: Ryan.stitt@denverwater.org <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 /> S' na re f Pe'mitte Cor orate Officer,Owner,or Documented Designee Date <br /> M-AF-04 <br />