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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: Thomas Eve <br /> Permittee Company: Butala Construction Company <br /> Address: 9000 CR 152 <br /> P.O. Box 907 <br /> Salida, CO 81201-9519 <br /> Phone Number: (719)539-2521 <br /> Fax Number: (719)539-2523 <br /> Email Address: To eve@butala.net <br /> Permitting Contact: Terri Bashton <br /> Company: Butala Construction Company <br /> Address: 9000 CR 152 <br /> P.O. Box 907 <br /> Salida, CO 81201 <br /> Phone Number: (719) 539-2521 <br /> Fax Number: <br /> Email Address: <br /> Inspection Contact: Terri Bashton <br /> Company: Butala Construction Company <br /> Address: 9000 CR 152 <br /> P.O. Box 907 <br /> Salida,CO 81201 <br /> Phone Number: (719) 539-2521 <br /> Fax Number: <br /> Email Address: C f v <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 /> 'i"' /,///, �I& --I <br /> Signature of Permittee, Corporate Officer, Owner,or Documented Designee Date <br /> M-AF-01 <br />