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STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY <br /> Department of Natural Resources <br /> SO 1 02 <br /> 1313 Sherman St.,Room 215 D O L Oi o N oO <br /> Denver,Colorado 80203 ,I n RECLAMATION <br /> Phone:(303) 2-8106 Y` � � S.1M/thm MINING <br /> FAX:(303)832-8106 rW' —&— <br /> SAFETY <br /> APPLICATION FORM <br /> FOR TRANSFER OF MINERAL PERMIT AND <br /> SUCCESSION OF OPERATORS RECEIVED <br /> ADMINISTRATIVE INFORMATION JAN 2 3 2020 <br /> DIVISION OF RFCLAMAT10N <br /> Permit Information MINING&SAFETY <br /> Permit Number: M-2013-054 <br /> Operation Name: Cotton Creek Pit <br /> 00 <br /> Permittee Information o v N <br /> Contact Person: Ken Skoglund a � <br /> w W <br /> Company Name: Skoglund Excavating Inc. o b <br /> street Address: 1075 Broadway Street <br /> city: Moffat <br /> State: Colorado Zip: 81143 <br /> Phone ( .719 ) 25 c..44.4 7 <br /> Email (optional): ]rj-f 6d�2n,5koq <br /> 0 <br /> t0lCl) <br /> Prospective Successor Information 0 OO <br /> Contact Person: <br /> Michael J. Slattery �3 5 NO <br /> Company Name: Kiana Holdings II, LLC <br /> Street Address: 3450 Big Bear Drive <br /> city: Sedalia <br /> State: Colorado Zip: 80135 <br /> Phone: (360 ) 930-4792 <br /> Email (optional): slatteryrnjsCa)gmail.corrl <br /> Office of Office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Active and <br /> Inactive Mines <br />