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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: Joel Konig <br /> Permittee Company: Konig Ag Co. <br /> Address: 37231 Hwy. 14 <br /> Briggsdale, CO 80611 <br /> Phone Number: (970) 656-3664 <br /> Fax Number: <br /> Email Address: <br /> Permitting Contact: Chris Rundall <br /> Company: Baseline Engineering Corp. <br /> Address: 1536 Cole Blvd., Suite 220 <br /> Golden, CO 80401 <br /> Phone Number: (303) 940-9966 <br /> Fax Number: (303) 940-9959 <br /> Email Address: <br /> Inspection Contact: Joel Konig <br /> Company: Konig Ag Co. <br /> Address: 37231 Hwy. 14 <br /> Briggsdale, CO 80611 <br /> Phone Number: (970) 656-3664 <br /> Fax Number: <br /> Email Address: <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 /> Sign re of Permitte , Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />