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County* <br /> Jefferson <br /> Enter one county only <br /> Site Name <br /> Golden Mine <br /> Perm ittee/Operator Name <br /> Denver Brick Company <br /> ADDITIONAL INFORMATION <br /> Are there supporting photos, maps, or documents you wish to upload? <br /> Yes No <br /> By submitting this form electronically you agree to receive any/all follow up correspondence from the Division of <br /> Reclamation, Mining,and Safety at the email address you have provided. <br />