Laserfiche WebLink
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 />00 <br />APPLICATION FORM <br />FOR TRANSFER OF MINERAL PERMIT AND <br />SUCCESSION OF OPERATORS <br />ADMINISTRATIVE INFORMATION <br />Permit Information <br />COLORADO <br />D I V I S ION OF <br />RECLAMATION <br />MINING <br />SAFETY <br />RECEIVEOW <br />APR 10 2015 <br />Permit Number: - - MUMGAWSAFETY <br />n <br />Operation Name: l t ) <br />Permittee Information <br />Contact Person: <br />Company Name: <br />Street Address: q( <br />City: <br />State: i'.7 <br />Zip: on1�`7 — <br />Phone: . 3 c .z <br />Email (optional): <br />Prospective Successor Information <br />Contact Person: <br />Company Name: <br />Street Address: ' <br />City: <br />I Zip: <br />State: � <br />Phone: q 7 U rA <br />Email (optional): t ✓ CkT f �&p y(f <br />Office of <br />Active and <br />Office of Denver - Grand Junction • Durango <br />Mined Land Reclamation <br />Inactive Mines <br />