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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: Clint Beck <br /> Permittee Company: Pete Lien& Sons, Inc. <br /> Address: P.O. Box 440 <br /> Rapid City, SD 57709-0440 <br /> Phone Number: (605)342-7224 <br /> Fax Number: (605)394-7246 <br /> Email Address: Cbeck@petelien.com <br /> Permitting Contact: ,�kel�p-EriclstYrr'— <br /> C. I NT '13.e,c.1� tl <br /> Company: Pete Lien and Sons, Inc. <br /> Address: P.O. Box 440 <br /> Rapid City, SD 57702 <br /> Phone Number: - <br /> ��ooS <br /> Fax Number: <br /> Email Address: <br /> Inspection Contact: B—Fidn Tideman <br /> Company: Pete Lien and Sons,Inc. <br /> Address: -o �o �joX �t f O <br /> Phone Number: - <br /> 690 S) 34f 2 - ?ZZ`/ <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 />