Laserfiche WebLink
1 <br /> STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING ANI7 SAFETY <br /> Department of Natural Resources <br /> A& <br /> 1313 Sherman St.,Room 215 C O L O RA D O <br /> Denver,Colorado 80203 D 1 V 1 s 1 o N o f <br /> Phone:(303)866-3567 I RECLAMATION <br /> FAX-(303)832-8106 1 MINING <br /> SAFETY <br /> APPLICATION FORM <br /> FOR TRANSFER OF MINERAL PERMIT ANDi <br /> SUCCESSION OF OPERATORS <br /> - RECEIVED <br /> ADMINISTRATIVE INFORMATION JAN 0 6 2016 <br /> DIVISION OF RECI AMATIM <br /> Permit Information MINING AND SAFETY <br /> Permit Number: ; G L� <br /> Operation Name:„ <br /> Permittee Information <br /> Contact Person: <br /> Company Name: 1 r- e,.... �`1L <br /> Street Address: <br /> City: L',1s1x1W- <br /> State: 0 Zip: <br /> Phone: /Gl ) ,�r� �a <br /> Email (optional): go tr'G�fr� €��1 C <br /> Prospective Successor Information � <br /> 3/avIlb <br /> Contact Person: L S <br /> Company Name: Q c�Wa >�r�� U tvl L 'f'e,9- <br /> Street Address: <br /> City: 6 n S" ( ✓ 5 D h <br /> State: C v Zip: <br /> Phone:("1,) 9 ) a S o�. p& 2_ <br /> Email (optional): P <br /> a e�f elf-'s I �� <br /> �I <br /> Office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Office of <br /> Inactive Mines Active and <br />