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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 />T� <br />Permittee Contact: <br />Thomas M. Eve <br />Permittec Company: <br />Butala Construction Company <br />Address: <br />9000 CR 152 <br />P.O. Box 9.07 <br />Salida, CO 81201-9519 <br />Phone -Number: <br />(719) 539-2521 <br />Fax Number: <br />(719) 539-2523 <br />Email Address: <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 />Signature of Permi ee, Corporate Officer,, Owner, or Documented Designee D to <br />M -AF -01 <br />