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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,NlWNG AND SAFETY <br /> Oep,orlmo-nt el Natural Retm,.cei <br /> 13!3 Sherman S!. Room 215 C O L O RA D O <br /> Div I S I O N OF <br /> Genver,Cciorado 80203 f /+ RECLAMATION <br /> Phcne.Q03)2c6-35V M I N I N G <br /> FAX.t303;832-SIH _& <br /> SAFETY <br /> APPLICATION FORM - <br /> FOR TRANSFER OF MINERAL PERMIT AND <br /> SUCCESSION OF OPERATORS <br /> ADMINISTRATIVE INFORMATION RECEIVED <br /> Permit Information JUL 11 2017 <br /> Pemiit Number: Jq L o 0_6 - C7 17) <br /> _Operation Name. r� �__� _ --- -- ------ o;, of Reclamation, <br /> fY?B n + n P - --------- _-- Mlning& Safety <br /> Permittee Information <br /> Coma;;[Person. !mot ! C <br /> Company Name: <br /> 414� <br /> State: <br /> Phone <br /> L1rlii ;cptx3n l): � �� —11-6 Af� l ' rr'rryLLPr Se ltc� �r�ILI <br /> Prospective Successor Information _t <br /> Contact Person: _e•��e r m 01'1 J J r o I L' ✓ <br /> J 111�rCr� <br /> •�-- or- t'Yl A R►A <br /> fit' Company dams .._ " mLLD I�IV L LC, <br /> Street.\ddre� : ! 4 _ C&I- 1 n O <br /> c1t y:(�' ,I o-r�t��—S <br /> -P - <br /> State: p U Y`lLC p Zip: <br /> ld-t-GL �OpDD �ru t•%IP2�o2�.( <br /> Email(nP ticxtal): A <br /> n <br /> Office of Off oe of <br /> Mined Land Reclarra!ior ewer•3r3r d!ureter•J r3ntic Ad:ve of <br /> Inactive Mines <br />