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STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY <br /> Department of Natural Resources <br /> COLORADO <br /> 1313 Sherman St.,Room 215 D IV IS 1 ON OF <br /> Denver,Colorado 80203 /� � RECLAMATION <br /> Phone:(303)866-3567 V MINING <br /> FAX:(303)832-8106 SAFETY <br /> APPLICATION FORM ,\ <br /> FOR TRANSFER OF MINERAL PERMIT AND <br /> SUCCESSION OF OPERATORS <br /> ADMINISTRATIVE INFORMATION 2, <br /> Tt5� <br /> Permit Information <br /> Permit Number: M-2004-061 <br /> Operation Name: Cottonwood Quarry RFCEUE.D <br /> Permittee Informations <br /> Contact Person: Russell A. Larsen MAR 2 <br /> Company Name: Everist Materials, LLC Division �fs� 1'atic4? <br /> Street Address: 28755 Highway 9 <br /> City: Silverthorne <br /> State: Colorado Zip: 80498 l� <br /> Phone:-( 970 ) 468-2521 kz <br /> Email (optional): <br /> Prospective Successor Information <br /> Contact Person: Russell A. Larsen <br /> Company Name: Kilgore Companies dba Peak Materials 0,LU[411 s11b <br /> Street Address: <br /> 556 Struthers Ave <br /> city: Grand Junction <br /> State: Colorado Zip: 81501 <br /> Phone:-( 970 ) 242 -5370 <br /> Email (optional): russ.larsen@elamconstruction.com or jon.mueller@elamconstruction.com <br /> Office of Office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Active and <br /> Inactive Mines <br />