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STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 RECEIVED COL O RA D O <br /> Denver,Colorado 80203 DIVISION o e <br /> RECLAMATION <br /> Phone:(303)866-3567 / r❑ MINING <br /> FAX:(303)832-8106 "��� SCr I I +,o I8 <br /> ---/// SAFETY <br /> APPLICATION FOR N�ANpSAFMArioN <br /> FOR TRANSFER OF MINERAL PERMIT RD <br /> SUCCESSION OF OPERATORS b04 <br /> WU'�� <br /> ADMINISTRATIVE INFORMATION <br /> Permit Information <br /> Permit Number: M-1995-009 <br /> Operation Name: Fasse Pit <br /> Permittee Information <br /> Contact Person: Michael B. Dorman <br /> Company Name: Dorman Brothers, LLC <br /> Street Address: 70 Webster Ave. <br /> city: Burlington <br /> State: Colorado Zip: 80807 <br /> Phone: (719 ) 346-8180 <br /> Email (optional): <br /> Prospective Successor Information ✓ P1'Nbr, I <br /> Contact Person: Michael B. Dorman aW -'q`1im <br /> Golden Grains LLC °`AAA- <br /> Company Name: , <br /> Street Address: <br /> 70 Webster Ave. NO aw <br /> city: Burlington <br /> State: Colorado Zip: 80807 <br /> Phone:-( 719 ) 346-8180 <br /> Email (optional): <br /> Office of Office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Active and <br /> Inactive Mines <br />