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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural R urces <br /> COLORADO <br /> 1313 Sherman St„Room 21 o IV t s t o N OF <br /> Denver,Colorado 80203 RECLAMATION <br /> Phone:(303)866-3567 MINING <br /> FAX.(303)832-8106 --&— <br /> SAFETY <br /> APPLICATION FORM <br /> f.��fID FOR TRANSFER OF MINERAL PERMIT AND <br /> ,: O2ti SUCCESSION OF OPERATORS <br /> �ON�FRDG ADMINISTRATIVE INFORMATION <br /> Permit Information <br /> Permit Number: M-2009-086 <br /> Operation Name: <br /> Pickering Family Pit <br /> Permittee Information <br /> Contact Person: mall <br /> Company Name: I•Imtstonc GravcI x'rrwbn�,IFw <br /> Street Address: 1204 CR 60 Box 950 <br /> City: Gmnn4 <br /> State: co Zip: 80446 <br /> Phone: 970 } 531-9670 <br /> Email (optional): tcrry�+ilintstonegravel.com <br /> Prospective Successor Information <br /> Contact Person: Nick waldmv <br /> Company Name: I-'Inttstonc Gravel Iht Inc. <br /> Street Address: 339 CR 5 Box 245 <br /> City: Fra cr <br /> State: co Zip: 80442 <br /> Phone: ( 970 531 -0977 <br /> Email (optional): nickl?nicksdirnvorkscom <br /> Office of Once of <br /> Mined Land Reclamation Denver-Grand Junction•Durango Active and <br /> Inactive M nes <br />