2015-09-03_REVISION - M2010034

• Permit No: M2010034
• IBM Index Class Name: REVISION
• Doc Date: 9/3/2015
• Doc Name: Succession of Operators Application SO01
• From: Willits/Syzygy Ent
• To: DRMS
• Type & Sequence: SO1
• Email Name: PSH
• Media Type: D
• Archive: No

DIVISION OF RECLAMATION, MINING AND SAFETY
Department of Natural Resources
1313 Sherman St., Room 215
Denver, Colorado 80203
Phone: [phone]
FAX: [phone]
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STATE OF COLOR A DO
5J-01
APPLICATION FORM
FOR TRANSFER OF MINERAL PERMIT AND
SUCCESSION OF OPERATORS
ADMINISTRATIVE INFORMATION
Permit Information
COLORADO
DIVISION OF
RECLAMATION
MINING
—
SAFETY
RECEIVED
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SEP 0 3 2015
Division of Reclamation,
Mining & Safety
Permit Number: "11 - ,2 O / p _ O *
Operation Name: j2C ,E1V,0,4 g
Permittee Information
Contact Person: B O Z3 I& l4 L/ 7--5
Company Name: W JLL 175 G o/Y7 PAA] Y ,T -,V c
Street Address: P 0. B o x 8Z
city: C�Hj6� lE/�//�/' , RECEIVED
State: ,/lJ Y Zip: &Z Oo_
Phone: ( 307 ) 6, ^ ,2 3a a 'JUN 19 201
Email (optional): Uiwiisi�rm of i§ ,,
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Prospective Successor Information
Contact Person: R / C K /W / 4 j- R
Company Nam(
Street Address:
y
city: -r =
State: Go Zip:—fA-r/ / �/�j8' LnP�V►0L
Phone:
�"A. a 5191 ! o
(q7D) 3.5.2 � �-�f - J�- �- UYV*
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Email (optional): rl ( eiXl w5cre d6dd,coro
Office of Office of
Mined Land Reclamation Denver • Grand Junction • Durango Active and
Inactive Mines