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STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY <br /> Department of Natural Resources <br /> COL O RA D O <br /> 1313 Sherman St.,Room 215 A <br /> SO-4 DIVISION OF <br /> Denver,Colorado 80203 NCG/JDM RECLAMATION <br /> Phone:(303)866-3567 MINING <br /> FAX.(303)832-8106 —&— <br /> SAFETY <br /> APPLICATION FORM <br /> FOR TRANSFER OF MINERAL PERMIT AND <br /> SUCCESSION OF OPERATORS R/F r) <br /> ADMINISTRATIVE INFORMATION SEp 12 2022 <br /> DIVISION OF RECLAMATION, <br /> MINING&SAFETY-MINERAL-.S <br /> Permit Information <br /> Permit Number: <br /> Operation Name: 71nQYn 6% Pd <br /> Permittee Information <br /> Contact Person: S+0n -T'hoyo b,,,,q <br /> Company Name: 7-he T"h oyn 6—, Fay►I 1 W Li rn i 4ent <br /> Street Address: 50-j41 E 3;?4t, Ave, <br /> City: Gem vie,4+ <br /> State: Co. Zip: A 0 1 0;L <br /> Phone:J 303 ) �*44 - 14aq <br /> Email (optional): <br /> Prospective Successor Information <br /> Contact Person: J o�n 1/ a (Llaw <br /> Company Name: Geme-4- CALL L-LL <br /> Street Address: 45`+5 yu( I G Plot <br /> City: P.Nhe,* <br /> State: . Zip: b1041 <br /> Phone: (-7a() ?7y <br /> Email (optional): ct 143 koss IDkh If_�MA I � . CoM <br /> Office of Office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Active and <br /> Inactive Mines <br />