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MAC WWE <br />M-1977-300 SOOT <br />,/Annual Fee/Report CW <br />J Vlolations: <br />MV2010018 <br />MV2010030 11.18/2010 <br />MV2012027 9/12/2012 <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 <br />AINING AND SAFETY <br />STATE OF COLORADO <br />RIEcEi ) <br />OCT 112017 <br />NI °i= EL4ManoN <br />APPLICATION FORM E* <br />FOR TRANSFER OF MINERAL PERMIT AND <br />SUCCESSION OF OPERATORS <br />ADMINISTRATIVE INFORMATION <br />Permit Information <br />Permit Number: M-1977-300 (Amendment 4) <br />Operation Name: Schwartzwalder Mine <br />Permittee Information <br />Contact Person: Ken Mushinski <br />Company Name: Cotter Corporation (N.S.L.) <br />Street Address: 7800 E Dorado Pl ,�,� I D <br />city: Greenwood Village <br />State: Colorado Zip: 80111 <br />Phone:-( 720 ) 554-6207 <br />Email (optional): ken.mushinski(q)_cotterusa.com <br />Prospective Successor Information <br />Contact Person: Jim Harrington <br />Company Name: Colorado Legacy Land, LLC <br />Street Address: 4601 DTC Blvd - Suite 130 <br />city: Denver <br />State: Colorado <br />Zip: 80237 <br />• ii <br />Phone: ( 970 ) 632-2239 <br />Email (optional): jimharrington@alexcoresource.com <br />COLORADO <br />DIVISION OF <br />RECLAMATION <br />MINING <br />SAFETY <br />office of office of <br />Mined Land Reclamation Denver • Grand Junction - Durango Active and <br />Inactive Mines <br />