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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 Arn (w �" �tCOLORADO OLORADO <br /> atvrsioN OF Colorado 80203 2 j/ �( 1Ovd IEcMNMANON <br /> Phone:( )866 <br /> FAX:(303)832-8106 5666 <br /> SAFETY <br /> APPLICATION FORM <br /> 1R TRANSFER OF MINERAL PERMIT AND <br /> SUCCESSION OF OPERATORS S°URECEIVED <br /> 1?0:p ADMINISTRATIVE INFORMATION DEC 2 7 Z019 <br /> LAIAAllON <br /> .!NOON OF �WINO AV <br /> Permit Information <br /> Permit Number: M-1977-3173 <br /> 0 3 <br /> Clay = <br /> Cedarwood Mine - 3 c° <br /> Operation Name: E. <br /> 44 <br /> Permittee Information <br /> N <br /> Contact Person: Joe Welte <br /> Company Name: Summit Brick and Tile Company, Inc. <br /> Street Address: 601 East 13th Street POBox 533 <br /> City: Pueblo <br /> State: Colorado Zip: 81002-0533 <br /> Phone: ( 719 ) 542-8278 <br /> Email (optional): ki 110 <br /> eN0 <br /> Fo- - N <br /> Prospective Successor Information <br /> Contact Person: Trent Stafford <br /> Company Name: Seifert Enterprises,LLC <br /> Street Address: P-7 g Rangeview Loop <br /> City: Westcliffe <br /> State: Colorado Zip: 81252 <br /> Phone: ( 719 ) 783-2757 <br /> Email (optional): trent@sbcompanies.com o►f. aam,n0_4,6 co m4V641,165 . M, <br /> Office of Office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Active and <br /> Inactive Mines <br />