2018-01-23_GENERAL DOCUMENTS - M1976056

• Permit No: M1976056
• IBM Index Class Name: General Documents
• Doc Date: 1/23/2018
• Doc Name Note: Request for S.O.
• Doc Name: Request for Documents/Information
• From: DRMS
• To: McAtee Construction Company / Simon
• Email Name: JLE
• Email Name: WHE
• Email Name: BJC
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF RECLAMATION, MINING AND SAFETY
Department of Natural Resources
tIRIECLAMATION
iA b
1313 Sherman St., Room 215 DIVISION OF
Denver, Colorado 80203
Phone: [phone] MINING
FAX: [phone] —&—
SAFETY
ETY
APPLICATION FORM
FOR TRANSFER OF MINERAL PERMIT AND
SUCCESSION OF OPERATORS
ADMINISTRATIVE INFORMATION
Permit Information
Permit Number:
Operation Name:
Permittee Information
Contact Person:
Company Name:
Street Address:
City:
State: Zip:
Phone: ( )
Email (optional):
Prospective Successor Information
Contact Person:
Company Name:
Street Address:
City:
State: Zip:
Phone: ( )
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Office of Office of
Mined Land Reclamation Denver • Grand Junction • Durango Active and
Inactive Mines