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"5"C' 16'v'm <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 />STATE OF COLORADO <br />APPLICATION FORM <br />FOR TRANSFER OF MINERAL PERMIT AND <br />SUCCESSION OF OPERATORS <br />ADMINISTRATIVE INFORMATION <br />Permit Information 5'0 0 2- <br />Permit Number: M-1986-004 <br />Operation Name: Brandstadt Rock Pit <br />Permittee Information <br />Contact Person: Gary Brandstadt - Personal Representative <br />Company Name: Estate of Harold Brandstadt <br />Street Address: 516 B Estate St. <br />City: Grand Junction <br />State: CO Zip: 81504 <br />Phone:-( 970 ) 241-4515 <br />Email (optional): <br />Prospective Successor Information <br />Contact Person: Melvin Brandstadt <br />Company Name: _ <br />Street Address: <br />City: Delta <br />State: CO <br />Phone: 9 7 0 <br />Email (optional): <br />n/a <br />19239 G Road <br />874 -7283 <br />Zip: 81416 <br />Office of <br />Mined Land Reclamation Denver • Grand Junction - Durango <br />Inactive Mines <br />_ /h \r\ t J- Ir\I)G <br />COLORADO <br />D I v I S I ON OF <br />RECLAMATION <br />MINING <br />SAFETY <br />RECEIVED <br />APR 18 2014 <br />DIVISION OF RECLAMATION <br />MINING AND SAFETY <br />Office of <br />Active and <br />