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STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING <br /> Department of Natural Resources <br /> COLORADO <br /> 1313 Sherman St.,Room 215S 0 0 DIVISION O F <br /> Denver,Colorado 80203 RECLAMATION <br /> Phone:(303)866-3567 M I N I N G <br /> FAX: (303)832-8106 ACY/thm SA& <br /> SAFETY <br /> APPLICATION FORM <br /> FOR TRANSFER OF MINERAL PERMIT AND <br /> SUCCESSION OF OPERATORS RECEIVED <br /> ADMINISTRATIVE INFORMATION <br /> MAY 0 4 2020 <br /> DIVISION OF RECLAMAM{y <br /> =MINING AND SAFEFy <br /> Permit Information 40 <br /> oE <br /> Permit Number: M1995005 51.a COW <br /> Orchard Mesa Aggregate <br /> Operation Name: b <br /> 0 <br /> Permittee Information N N <br /> Contact Person: Sandra R Ducray <br /> Company Name: Orchard Mesa Aggregate <br /> Street Address: 117 29 3/4 Rd <br /> City: Grand Junction <br /> State: CO Zip: 81503 <br /> O <br /> �70 ) 242-5461 ' Ioy <br /> Phone: E <br /> o <br /> o <br /> Email (optional): <br /> Prospective Successor Information <br /> Contact Person: David Forenza <br /> Company Name: Mesa Agg LLC <br /> Street Address: PO BOX 7790 <br /> City: Avon <br /> State: CO Zip: 81632 <br /> Phone: ( ) <br /> Email (optional): dforenza@gmail.com <br /> Office of Office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Active and <br /> Inactive Mines <br />