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F � / <br /> STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 p O:4�1 <br /> ro NDDenver,Colorado 80203 / /� REMATIO <br /> Phone:(303)866-3567 50'G1!/ MINING <br /> FAX:(303)832-8106 —&— <br /> SAF ETY <br /> APPLICATION FORM <br /> FOR TRANSFER OF MINERAL PERMIT AND <br /> SUCCESSION OF OPERATORS <br /> RECEIVED <br /> ADMINISTRATIVE INFORMATION MAR 2 i j j 7 <br /> Divisir;+o``eclamation, <br /> Permit Information Marling&Safety <br /> Permit Number: M-1998-052 <br /> Operation Name: Mascot Placer <br /> Permittee Information <br /> Contact Person: Russell A. Larsen <br /> Company Name: Everist Materials, LLC <br /> Street Address: 28755 Highway 9 <br /> City: Silverthorne I �� <br /> State: Colorado Zip: 80498 � <br /> )Phone: ( <br /> 970 468-2521 V Email (optional): L/ n <br /> Md <br /> Prospective Successor Information <br /> P <br /> Contact Person: Russell A. allL -1/Z--07 <br /> Company Name: Kilgore Companies dba Peak Materials <br /> Street Address: 556 Struthers Ave <br /> city: Grand Junction <br /> State: Colorado Zip: 81501 <br /> Phone: ( 970 ) 242 -5370 <br /> Email (optional): russ.larsen@elamconstruction.com or jon.mueller@elamconstruction.com <br /> Office of Office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Active and <br /> Inactive Mines <br />