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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: Harriet S.Graham <br /> Permittee Company: Bad Boys of Cripple Creek Mining <br /> Co., Ine.1.6 c <br /> Address: 1429 Locust Drive <br /> Canon City,CO 81212 <br /> i <br /> Phone Number: (719)276-0065 <br /> I <br /> Fax Number: (719)276-0065 <br /> Email Address: Worldwidetreasures08@yahoo.com <br /> Permitting Contact: David Q.Gmhafn N if R A r 6,7— S /c( <br /> Company: Bad Boys of Cripple Creek Mining <br /> Co. Ise.LGe l <br /> Address: 1Ue /� <br /> 1�$�e -6Cr 3 Ca,I—, U� 8/z12, <br /> Phone Number: (719)689=- 9 2 <br /> Fax Number: UM14000" <br /> -o 046-- <br /> Email Address: <br /> GcbRl�r�,-�E - SuR�saQ'�' <br /> Inspection Contact: <br /> Company: Bad Boys of Cripple Creek Mining 17 <br /> Co. hjc,44C- <br /> Address: 2 Bennett Avenue <br /> P.O. Box <br /> Cripple Creek,C 13 �0;A <br /> Phone Number: <br /> Fax Number: <br /> Email Address: <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. <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br />