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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 <br /> print current contact information: <br /> Permittee Contact: Rick L. Hunt <br /> Permittee Company: Rick L Hunt <br /> Address: 43160 County Rd 17-21 <br /> Elizabeth, CO 80107 <br /> Phone Number: (303)646-6486 <br /> Fax Number: (303)646-9233 -516 <br /> Email Address: <br /> JC Y1y-i rVl(..r'1 ��'J lV'i��IY <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.b h'.�vtitc '(4 �`\tilt 1fS1" 1'>iF`>i L.1 I CT <br /> SigHature of ermittee, Corporate Officer, Owner,or Documented Designee Date <br /> M-AF-01 <br />