2016-06-21_REVISION - M2010034

• Permit No: M2010034
• IBM Index Class Name: Revision
• Doc Date: 6/21/2016
• Doc Name: Conversion Application Receipt
• From: DRMS
• To: McEndfaffer Mine
• Type & Sequence: CN1
• Email Name: PSH
• Email Name: WHE
• Media Type: D
• Archive: No

-3-
11. Correspondence Information:
APPLICANT/OPERATOR (name,address,and phone of name to be used on permit)
Contact's Name: Rick Miller Title: President
Company Name: SYZYGY Enterprises LLC
Street/P.O.Box: 1011 11th Avenue P.O.Box:
City: Greeley
State: Co Zip Cade: 80631
Telephone Number (970 _ 3524444 or cell 970-381-6121
Fax Number: (970 )_ 353-0139
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Title:
Company Name:
Street/P.O.Box: P.O.Box:
City:
State: Zip Code:
Telephone Number: { )Fax Number: -
INSPECTION CONTACT
Contact's Name: Jack Miller Title:V. President
Company Name: SYZYGY Enterprises LLC
Street/P.O.Box: 1011 11th Avenue P.O.Box:
City: Greeley
State: Co Zip Code: 80631
Telephone Number: (970 )_ 352-4444 or cell 970-573-8020
Fax Number: (970 )_ 353-0139
CC: STATE OR FEDERAL LANDOWNER(if any)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: { )-
CC: STATE OR FEDERAL LANDOWNER(if any
Agency.
Street:
City:
State: Zip Code:
Telephone Number. ( }-