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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: Carl F.Dismant <br /> 4'Jt E. <br /> Permittee Company: Bachelor Silver Mines Company <br /> -- / uc- s <br /> Address: P.O. Box 965 <br /> Ouray,CO 81427 <br /> CS <br /> Phone Number: (970)325-4665 <br /> tS <br /> Fax Number: <br /> Email Address: x � � <br /> Permitting Contact: Carl Dismant <br /> CS <br /> Company: Bachelor Silver Mines Company <br /> Address: 325 5th St <br /> P.O. Box 965 <br /> Ouray,CO 81427 <br /> es <br /> Phone Number: (970)325-4665 <br /> e.S" <br /> Fax Number: <br /> Email Address: <br /> Inspection Contact: Carl Dismant <br /> C J ' <br /> Company: Bachelor Silver Mines Company ` <br /> /1 1 —/ — / �I <br /> Address: 325 5th St <br /> P.O. Box 965 <br /> Ouray,CO 81427 <br /> Phone Number: (970)325-4665 <br /> Fax Number: <br /> r <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 /> -- ,�- f - <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-02 <br />