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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: Fred A. Duckels <br /> Permittee Company: Duckels Construction, Inc. <br /> Ct,1 v- r-� ✓�� <br /> Address: 3500 Duckels Court <br /> Steamboat Springs,CO 80487 <br /> Phone Number: (970)879-6072 <br /> Fax Number: (970)879-6748 <br /> Email Address: Duckelscheryl@aol.com , <br /> Permitting Contact: Bruce Humphries <br /> Company: Regulatory Permits q <br /> Management, Inc. L v C.¢.a� CL)Yy ''Y l 1 6�1 b h <br /> Address: 7425 Winter Beryy Ln C� ���� (ACastle Rock, CO 80108 <br /> Phone Number: (303)854-7499 <br /> Fax Number: (303)660-3852 C) -1 C� _ r <br /> Email Address: Cl-tA-C C, C V- <br /> Inspection Contact: Fred Duckels / <br /> Company: Duckels Construction, Inc. <br /> Address: 3500 Duckels Court <br /> Steamboat Springs,CO 80487 <br /> Phone Number: (970)879-6072 �`�LL�,-1r��..✓'t <br /> Fax Number: (970)879-6748 ` r <br /> Email Address: Duckelscheryl@aol.com <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 /> 7 <br /> Sign ture Per ee r orate ob icer, ner,or Documented Desiznee Date <br /> M-AF-01 <br />