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STATE OF COLORADO <br /> DIVISION OF RECLAMATION, ' TY <br /> Department of Natural Resource, <br /> ( COLORADO <br /> 1313 Sherman St.,Room a ]DIVISION OF <br /> Denver,Colorado 802r' Nia� RECLAMATION <br /> Phone:(303)866-3r' MINING <br /> FAX:(303)832-9 " St- <br /> 0 SAFETY <br /> z 0�5' APPLICATION FORM <br /> 0O�ea o\a�� OR TRANSFER OF MINERAL PERMIT AND <br /> SUCCESSION OF OPERATORS RECEIVE, <br /> t <br /> eerA At c,` 7o/7 . 3 3 90 . 000 0. 008. 4,;UJI <br /> �p r APR 2 7 2018 <br /> ADMINISTRATIVE INFORMATION DMSION Oc RECLAMATc_ , <br /> MINING AND SAFEry <br /> Permit Information <br /> Permit Number: M2003003 <br /> Operation Name: AmZak Pit <br /> Permittee Information <br /> Contact Person: Joe Kozirnor <br /> Company Name: Consolidated Constructors, Inc. <br /> Street Address: PO Box 629/1370 Highway 371 <br /> City: Farmington <br /> State: N M Zip: 87499 <br /> Phone: ( ) 505-326-7771 fax 505-326-7774 <br /> Email (optional): ioek(cD_consolidatedconst.com <br /> Prospective Successor Information <br /> Contact Person: Dawn Richardson or Craig Kemple <br /> Company Name: Richardson Construction Co. LLC & Kemple Excavation, LLC <br /> Street Address: 3940 C.R. 119 <br /> city.: Hesperus <br /> State: Colorado Zip: 81326 <br /> Phone: ( )970-759-8463 or 970-946-0023 <br /> Email (optional): pauldawn13@yahoo.com, kemplecraig@yahoo.com <br /> Permit contact: Nathan A. Barton, WASTELINE, Inc. (605)939-0650 Wasteline.80631 @gmail.com <br /> Office of Office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Active and <br /> Inactive Mines <br />