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i(jk <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 60203 <br />Phone (303)866-3567 <br />FAX: (303) 832-8106 <br />STATE OF COLORADO <br />APPLICATION FORM <br />FOR TRANSFER OF MINERAL PERMIT AND <br />SUCCESSION OF OPERATORS <br />ADMINISTRATIVE INFORMATION <br />Permit Information <br />Permit Number: M-2006-017 <br />COLORADO <br />D IVI S 1 ON OF <br />RECLAMATION <br />MINING <br />SAFETY <br />RECEIVED <br />JAN 10 2018 <br />" <br />VISION Or RECLAMATION <br />Operation Name: Jemadojin Sand Mine M)NINGANDSAFETY <br />Permittee Information <br />Contact Person: Jeffrey M. Jindra or Maria L. Jindra <br />Company Name: Jemadojin, LLC <br />Street Address: 16449 Dearing Road <br />city: Colorado Springs, CO <br />State: Colorado Zip: 80928 <br />Phone: (719 ) 683-3437 <br />Email (optional): m'indra2002 ahoo.com or 'eff indra ahoo.com <br />j j-�LL <br />Prospective Successor Information <br />Contact Person: Charles Wesley, IV <br />Company Name: Sand Acquisition Holdings, LLC <br />Street Address: 3033 E. 1 st Ave, Suite 837 <br />city: Denver <br />State: Colorado <br />Zip: 80206 <br />Phone: ( 720 ) 883-2966 <br />Email (optional): cwesley@thoroughbredip.com <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Active and <br />Inactive Mines <br />