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STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 DO <br /> p O L Or o N of <br /> Denver,Colorado 80203 RECLAMATION <br /> Phone:(303)866-3567 MINING <br /> FAX (303)832-8106 i <br /> SAFETY <br /> APPLICATION FORM <br /> FOR TRANSFER OF MINERAL PERMIT AND <br /> SUCCESSION OF OPERATORS <br /> ADMINISTRATIVE INFORMATION <br /> Permit Information <br /> Permit Number: M-2004-028 RECEIVED <br /> Operation Name: The Broyles Pit FB 212017 <br /> Permittee Information <br /> Jose h Febbraro `�ri)mon of ftdamatlon, <br /> Contact Person: p t,,ninip.g&saff4y <br /> Company Name: Febbraro Construction Co. <br /> Street Address: 2010 Santa Fe Trail <br /> city: Trinidad <br /> State: CO Zip: 81082 <br /> Phone: ( 719 ) 846-7789 ,/'Y✓L&41 <br /> Email (optional): febbraro construction(d-)hotmail.com itzc- <br /> ✓� $1,t+" <br /> Prospective Successor Information N ,�( or <br /> Contact Person: Michele M. Eichler r()t µJ <br /> Company Name: Frederick V. Eichler IV and Michele M. Eichler 0n4'CA- &44/; a <br /> Street Address: 22250 CR 44 OAXP 112,1111 <br /> city: Aguilar <br /> State: CO Zip: 81020 <br /> Phone: ( 719 )941-4392 <br /> Email (optional): micheleeichler614@gmail.com <br /> Office of Office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Active and <br /> Inactive Mines <br />