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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: George E. Otten <br /> Permittee Company: Central City Consolidated Mng <br /> Address: C/o Hunter Gold Mining Corp G 60k C <br /> 11438 Weld County Rd.19 �� 3� �,�+� �uNf 9 <br /> Fort Lupton, CO 80621 <br /> Phone Number: (970)785-2538 <br /> Fax Number: (970)785-6248 <br /> Email Address: OZ?Z 73,J'& 0 L, <br /> Permitting Contact: George E. Otten <br /> Company: Central City Consolidated Mng <br /> Address: o (�.�p f�► LZ C07LCV <br /> 11438 Weld County Rd. 19 <br /> Fort Lupton,CO 80621 <br /> Phone Number: (970)785-2538 <br /> Fax Number: 70 ^ 7,F5- � D <br /> Email Address: <br /> Inspection Contact: George E. Otten <br /> Company: Central City Consolidated Mng <br /> Address: <br /> 11438 Weld County Rd. 19 <br /> Fort Lupton,CO 80621 <br /> Phone Number: (970)785-2538 <br /> Fax Number: >a <br /> Email Address: G0 Q i <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 /> 06 b 0/'7 <br /> Signature of ermittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-02 <br />