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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: J94nt D - <br /> 1��,�-�J <br /> Permittee Company: Pete Lien& Sons, Inc. <br /> Address: P.O. Box 440 <br /> Rapid City, SD 57709-0440 <br /> Phone Number: <br /> Fax Number: - <br /> Email Address: ;�(ewror� <br /> © ef.t.co0.-1 <br /> Permitting Contact: CUNT ��c/L <br /> Company: Pete Lien& Sons,Inc. <br /> Address: P.O. Box 440 <br /> Rapid City, SD 57709-0440 <br /> Phone Number: - <br /> Fax Number: (&o,5 \ S4-2 - <br /> Email Address: L"Be-k- �e/1 evt ' Lov / <br /> Inspection Contact: / I/ <br /> Company: Pete Lien& Sons,Inc. <br /> Address: P.O. Box 440 <br /> Rapid City, SD 57709-0440 <br /> Phone Number: (605)342-7224 <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 /> u2r��- 41 3���� <br /> Signature of Permittee, Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />