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Page 5 of 5 <br /> Division records indicate the following permittee/landowner contact information(blank fields indicate that we do not have <br /> information on record). If this information is blank or not current,please type or print current contact information: <br /> Permittee Contact: David Cressler <br /> Permittee Company: Coal Bed Creek Construction, <br /> Inc. <br /> Address: 3689 Road 1.7 <br /> Dove Creek, CO 81324 <br /> Phone Number: (970)677-2797 <br /> Fax Number: (970)677-3797 <br /> Email Address: Cbci@centurytel.net <br /> Permitting Contact: David Cressler <br /> Company: Coal Bed Construction,Inc. <br /> Address: 3689 Road 1.7 <br /> Dove Creek,CO 81324 <br /> Phone Number: (970)677-2797 <br /> Fax Number: (970)677-3797 <br /> Email Address: Cbci@centurytel.net <br /> Inspection Contact: David Cressler <br /> Company: Coal Bed Creek Construction, <br /> Inc. <br /> Address: 3689 Road 1.7 <br /> Dove Creek,CO 81324 <br /> Phone Number: (970)677-2797 <br /> Fax Number: (970)677-3797 <br /> Email Address: Cbci@centurytel.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 Permittee, Corporate Officer, Owner, or Documented Designee Date <br /> M-AF-01 <br />