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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: Christopher L.Varra <br /> Permittee Company: Varra Companies, Inc. <br /> Address: 8120 Gage St. <br /> Frederick,CO 80516 <br /> Phone Number: (303)666-6657 <br /> Fax Number: <br /> Email Address: <br /> Permitting Contact: Christopher L.Varra <br /> Company: Varra Companies, Inc. <br /> Address: 8120 Gage Street <br /> Frederick, CO 80516 <br /> Phone Number: (303)666-6657 <br /> Fax Number: <br /> Email Address: <br /> Inspection Contact: Christopher L. Varra <br /> Company: Varra Companies, Inc. <br /> Address: 8120 Gage Street <br /> Frederick,CO 80516 <br /> Phone Number: (303)666-6657 <br /> Fax Number: <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 /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />