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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: Martin R.Bauer <br /> Permittee Company: JUBILEE VENTURE LLC <br /> Address: 19754 E Euclid Dr <br /> Centennial, CO 80016 <br /> Phone Number: (720)289-1455 <br /> Fax Number: (303)693-0601 <br /> Email Address: <br /> Permitting Contact: Martin R.Bauer �J C, f! A)Pr <br /> Company: Jubilee Venture, LLC <br /> Address: 19754 E Euclid Dr <br /> Centennial, CO 80016 <br /> Phone Number: (303)617-1813 <br /> Fax Number: (303)693-0601 <br /> Email Address: a&) t usr A r <br /> Inspection Contact: Martin R.Bauer <br /> Company: Jubilee Venture,LLC <br /> Address: 19754 E Euclid Dr <br /> Centennial,CO 80016 <br /> Phone Number: (303)617-1813 <br /> Fax Number: (303)693-0601 <br /> Email Address: dm&f g.A)Wr' <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 /> MWAI� V4117 <br /> Signatu a of Permitt<Cornorate Officer,Owner,or Documented Designee Date <br /> M-AF-02 <br />