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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: Fred F. Wilson <br /> Permittee Company: Way Up High Mining Company, <br /> LLC <br /> Address: 95 Nettle Creek Road <br /> Carbondale, CO 81623 <br /> Phone Number: (970)379-1934 <br /> Fax Number: <br /> Email Address: <br /> Permitting Contact: Fred F.Wilson <br /> Company: Way Up High Mining Company, <br /> LLC <br /> Address: 95 Nesttle Creek Road <br /> Carbondale, CO 81623 <br /> Phone Number: (970)379-1934 <br /> Fax Number: <br /> Email Address: <br /> Inspection Contact: Fred F. Wilson <br /> Company: Way Up High Mining Company, <br /> LLC <br /> Address: 95 Nettle Creek Rd <br /> Carbondale, CO 81623 <br /> Phone Number: (970)379-1934 <br /> Fax Number: <br /> Email Address: <br /> 1,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-02 <br /> 001 t4j J16► 9��a/t6 , 911t /t6, 9/aq 116141';?Y116, -719117, -719/1Z, <br /> -7rath71 �1�a�11?� a..j '7/9310 S,csccwpUl w:4 A :...c:.C-.. . <br />