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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: Barbara E.Hubbs <br /> Permittee Company: Hubbs III, LLC <br /> Address: 367 CR 129 <br /> Hesperus,CO 81326 <br /> Phone Number: (970) 588-3309 <br /> Fax Number: <br /> Email Address: Barbarahubbs@gmail.com <br /> Permitting Contact: Barbara E.Hubbs <br /> Company: Hubbs III,LLC <br /> Address: E Saddtubackl3i 367 C! <br /> � e rtl5, (6 <br /> � .�P <br /> Phone Number: (928)303-3730 <br /> -5 <br /> Fax Number: <br /> Email Address: / <br /> C o <br /> Inspection Contact: Barbara E. Hubbs <br /> Company: Hubbs III, LLC <br /> Address: <br /> Phone Number: (928)303-3730 -7® <br /> Fax Number: <br /> Email Address: 11'^ <br /> I,the undersigned,hereby state that the information provided in this report is true and accurate, and that s to perations are <br /> being conducted in rdance with the Division approved mining and reclamation plans. <br /> r7 <br /> Si nature of Permittee,Corporate Officer,Owner,or Documented Designee Z a e <br /> M-AF-01 <br />