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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: Kevin Anderson <br /> Permittee Company: Connell Resources,Inc. <br /> Address: 7785 Highland Meadows Pkwy., <br /> Ste. 100 <br /> Fort Collins,CO 80528 <br /> Phone Number: (970)223-3151 <br /> Fax Number: (970)223-3191 <br /> Email Address: <br /> Permitting Contact: Greg Lewicki <br /> Company: Greg Lewicki and Associates <br /> Address: 11541 Warrington Court <br /> Parker,CO 80138 <br /> Phone Number: (303)346-5196 <br /> Fax Number: (303)346-6934 <br /> Email Address: <br /> Inspection Contact: <br /> ►— <br /> Company: Connell Resources,Inc. <br /> Address: 7785 Highland Meadows Pkwy., <br /> Ste. 100 <br /> Fort Collins,CO 80528 <br /> Phone Number: (970)223-3151 <br /> Fax Number: (970)223-3191 <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 /> Sig ture of Permittee,Corporate Officer,Owner,or Documented Desienee Date <br /> M-AF-01 <br />