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m 2vvv017 <br /> STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St., Room 215 2 COLORADO <br /> ION OF <br /> Denver,Colorado 80203 '3 RECLDIVIAMATION <br /> Phone:(303)866-3567 S� MINING <br /> FAX:(303)832-8106 —&— <br /> SAFETY <br /> APPLICATION FORM <br /> FOR TRANSFER OF MINERAL PERMIT AND <br /> SUCCESSION OF OPERATORS <br /> ADMINISTRATIVE INFORMATION P41P t t—2.ot g <br /> RECEIVED <br /> Permit Information JAN 10 2018 <br /> Permit Number: M-2006-017 <br /> DMSION OF RECLAMATION <br /> Operation Name: Jemadojin Sand Mine MINING ANDSAFEW <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): mjindra2002@yahoo.com or jeffjindrac yahoo.com <br /> Prospective Successor Information <br /> Contact Person: Charles Wesley, IV /Aim , <br /> Company Name: Sand Acquisition Holdings, LLC 6.-w <br /> Street Address: <br /> 3033 E. 1st Ave, Suite 837 sue 0.13_IS, <br /> City: Denver t/iO (1 <br /> State: Colorado Zip: 80206 WP,42 <br /> Phone: ( 720 ) 883-2966 <br /> Email (optional): cwesley@thoroughbredlp.com <br /> Office of Office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Active and <br /> Inactive Mines <br />