2016-08-24_GENERAL DOCUMENTS - M1983164

• Permit No: M1983164
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Date: 8/24/2016
• Doc Name: Request for Tsf of Permit and S.O. Application Permit - Response
• From: DRMS
• To: George F. Gallegos
• Email Name: DMC
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF RECLAMATION, MINING AND SAFETY
Department of Natural Resources
1313 Sherman St.,Room 215 COLORADOD IVI S I ON OF
Denver,Colorado 80203 RECLAMATION
Phone.[phone] MINING
FAX:[phone] —&—
SAF ETY
APPLICATION FORM
FOR TRANSFER OF MINERAL PERMIT AND
SUCCESSION OF OPERATORS
ADMINISTRATIVE INFORMATION
Permit Information
Permit Number:
Operation Name:
Permittee Information
Contact Person:
Company Name:
Street Address:
City:
State: Zip:
Phone: ( )
Email (optional):
Prospective Successor Information
Contact Person:
Company Name:
Street Address:
City:
State: Zip:
Phone: ( )
Email (optional):
Office of
Office of
Mined Land Reclamation Denver•Grand Junction•Durango Active and
Inactive Mines