2020-06-26_REVISION - M1979192

• Permit No: M1979192
• IBM Index Class Name: REVISION
• Doc Date: 6/26/2020
• Doc Name: Request For Amendment To Permit
• From: Rockbottom, LLC
• To: DRMS
• Type & Sequence: AM1
• Email Name: TC1
• Email Name: MAC
• Email Name: AWA
• Media Type: D
• Archive: No

-3 -
11. Correspondence Information:
APPLICANT/OPERATOR (name,address,and phone of name to be used on permit)
Contact's Name: Rebecca and Andy Kagan Title: Owners
Company Name: RockBottom, LLC
Street/P.O.Box: 555 Ernest Ave. P.O. Box:
City: Westclifffe
State: Colorado Zip Code: 81252
Telephone Number: L719 )_ 783-9636
Fax Number: (719 )_ 783-9636
PERNUTTING CONTACT (if different from applicant/operator above)
Contact's Name: Kenneth S. Klco Title: Consulting Geologist
Company Name: Azurite, Inc.
Street/P.O.Box: 10001 CR 12 P.O.Box: 338
City: Cotopaxi
State: Colorado Zip Code: 8 1223
Telephone Number: (719 )_ 942-4178
Fax Number: (na )_
INSPECTION CONTACT
Contact's Name: Rebecca Kagan Title: Owner
Company Name: Rockbottom, LLC
Street/P.O.Box: 555 Ernest Ave. P.O.Box:
City: Westcliffe
State: Colorado Zip Code: 81252
Telephone Number: (719 )_ 783-9636
Fax Number: (719 )_ 783-9636
CC: STATE OR FEDERAL LANDOWNER(if any
Agency: na
Street:
City:
State: Zip Code:
Telephone Number: ( )-
CC: STATE OR FEDERAL LANDOWNER(if any)
Agency: na
Street:
City:
State: Zip Code:
Telephone Number: ( )-