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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: Robert Tibbetts <br /> Permittee Company: The Denver Brick Company <br /> Address: 401 Prairie Hawk Dr. <br /> Castle Rock, CO 80109 <br /> Phone Number: (303)688-6951 <br /> Fax Number: (303)688-9894 <br /> Email Address: Rtibbets@brick.com <br /> Permitting Contact: Paul Banks <br /> Company: Banks and Gesso, LLC <br /> Address: 720 Kipling Street, Suite 117 <br /> Lakewood, CO 80215 <br /> Phone Number: (303)274-4277 <br /> Fax Number: (303)274-8329 <br /> Email Address: <br /> Inspection Contact: Robert Tibbetts <br /> Company: The Denver Brick Company <br /> Address: 401 Prairie Hawk Dr. <br /> Castle Rock,CO 80109 <br /> Phone Number: (303)688-6951 <br /> Fax Number: (303)688-9894 <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 /> .7 <br /> Signature of Permittee,Corporate O icer,Owner,or Documented Designee ate <br /> M-AF-01 <br />