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C�� www <br />m 0 77015 <br />STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 SO -01 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 <br />APPLICATION FORM <br />FOR TRANSFER OF MINERAL PERMIT AND <br />SUCCESSION OF OPERATORS <br />ADMINISTRATIVE INFORMATION <br />COLORADO <br />D IVI S ION O F <br />RECLAMATION <br />MINING <br />SAFETY <br />Permit Information <br />Permit Number: M - 1977 - 075 <br />Operation Name: Holyoke Gun Club Pit <br />Permittee Information <br />Contact Person: Kendra Schlachter <br />Company Name: Holyoke Gun Club ocr,G�i� <br />Street Address: 45037 CO. Rd. 24 ��(TiL% <br />city: Holyoke �Ut X611 <br />State: Colorado Zip: 80734 d101eh Of R60066fil <br />Phone: ( 308 ) 249-5294 <br />Email (optional): <br />Prospective Successor Information <br />Contact Person: Randy Schafer <br />Company Name. Phillips County <br />Street Address: 221 S. Interocean Ave. <br />Cit,: Holyoke <br />State: Colorado Zip: 80734 <br />Phone: ( 970 ) 854-3778 <br />Email (optional): randy.schafer@phillipscounty.co <br />Office of Office of <br />Mined Land Reclamation Denver - Grand Junction • Durango Active and <br />Inactive Mines <br />