2015-05-11_REVISION - M2014045

• Permit No: M2014045
• IBM Index Class Name: REVISION
• Doc Date: 5/11/2015
• Doc Name: Notices
• From: DRMS
• To: Mineral Mountain Gold, LLC CN01
• Type & Sequence: CN1
• Email Name: TC1
• Media Type: D
• Archive: No

H
CoMRoadence IafoimaAN
_ AMJQOI OPERATOR (name, address, and phone of name to be used on permit)
Contads Name: Lance Bariter Title: P-f"WhIt _
Company Name: Mineral. Mountain Oold, LLP-.
Street/P.O. Boicc
P.O. Bo'x:
City:
Cripple Crook
State:
COIOnIdO _ _
_ Zip Code: 80813
Telephone Number:
('T19 ) L 689-.50-65-
89-5965Fax
FoxNumbdi:
EItMITTiN(I CONTACT
(if different f}±ntri a0hoot/Operit" above)
Contact's Nde:.
1 -since. Barker
Tide: President
Company Name:
Mineral Mou�itdin Goil, LLC
_
Street/P.O. Box:
P.O. Box: 2 47
City:
Cripple Creek
gam.
Colorado
Z;p Code:
Telephone NumW. (719. ; -) -
Fax Number:
e ksm-
Contact's Name:
Company Name:
Street/I'.O. Box:
City:
Carlos Barker _Title: President
Mineral Mountain Gold, LLC
_ P:O. Box: 247
Stat . a.anviauv Zip Code: F"o''.
TeIpphooe Number.(719 ) _689-596�v y
Pax Number
CC_:. STATE OR FEDERAL LANDOWNER (if V.
Agnq'NOtAp
plippble
Street:
City:-
$tate; - Zip Code:
Telephone Number.
CC: STATE OR FEDERAL 4AND22=9 (i w)
Agency
Street:
City: _ ... —
State: Zip -Code
Telephone Number: