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++STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFET E C <br /> Department of Natural Resources SO-3 <br /> 1313 Sherman SL,Room 215 MAR 14 2022 BFBIMAC b O L O o N oO <br /> Denver,Colorado 80203 RECLAMATION <br /> Phone:(303)886r3587 DIVISION OF RECLAMATION, MINING <br /> FAX:(303)832-8106 MINING&SAFETY-MINERALS <br /> SAFETY <br /> D APPLICATION FORM <br /> C _- FOR TRANSFER <br /> SUCCESSION OFOPERATORS R IT AND <br /> ADMINISTRATIVE INFORMATION <br /> Permit Information <br /> Permit Number: --O`7T <br /> Operation Name: <br /> Permittee Information ) <br /> Contact Person: aP, <br /> Company Name: A +T Ye 7k c 7ov�'4"C.Q/Ict rid LL[, <br /> Street Address: rj <br /> City: <br /> State: C Zip: qc)�oL k <br /> Phone: (g 70 ) '~S a a— URD-7 <br /> Email (optional): V e-'I c r 1 t to d "f (9 V m,'0O .co ni <br /> Prospective Successor Information <br /> Contact Person: . .Y`�I_ L IV <br /> Company Name: <br /> Street Address: 2A 7—1 Inj be stf LZ_t=L� <br /> City: <br /> State: C i byad o Zip: &A-dI <br /> Phone: Qm ) ALM c a I(D <br /> Email (optional): bMMe,V Vr) �!1 �/�lfC•i ' 0 U�- C(D �. <br /> Office of Office of <br /> Mined Land Reclamation Denver•Grand Junction-Durango Active and <br /> Inactive Mines <br />