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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX- (303) 832 -8106 <br />APPLICATION FORM <br />RECEIVED FOR TRANSFER OF MINERAL PERMIT AND <br />OCT 16 2013 SUCCESSION OF OPERATORS <br />DM" OF RECLAMATION <br />MININGANOSVM ADMINISTRATIVE INFORMATION <br />Permit Information <br />Permit Number: M- 1997 -087 <br />Operation Name: Hartman Fit <br />Permittee Information <br />Contact Person: Steve Brown <br />Company Name: Lafarge West, Inc. <br />Street Address: 10170 Church Ranch Way #200 <br />city: Westminster <br />State: CO Zip: 80021 <br />Phone: X03 ) 502 -7074 <br />Email (optional): steyen.t. brown (a-)_lafarge- na.com <br />Prospective Successor Information <br />Contact Person: Rick Glllan <br />Company Name: Arnold's Custom Seeding, LLC <br />Street Address: 4626 WCR 65 <br />city: Keenesburg <br />State: CO Zip: 80643 <br />Phone: (303 )732 -4021 <br />Email (optional): rgillan @acsseeding.com <br />410V� <br />Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango <br />COLORADO <br />D IV IS I ON OF <br />RECLAMATION <br />MINING <br />SAFETY <br />Office of <br />Active and <br />