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STAVk6MQL0RAD0 <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources II II J 2 8 2023 <br /> UU COLORADO <br /> 1313 Sherman St.,Room 215 D I V I S I O N o f <br /> Denver,Colorado 80203 DIVISION OF RECLAMATION, RECLAMATION <br /> Phone:(303)866-3567 MINING&SAFETY-MINERALS MINING <br /> FAX:(303)832-8106 —&— <br /> SAF ETY <br /> 19 <br /> APPLICATION FORM <br /> FOR TRANSFER OF MINERAL PERMIT AND <br /> SUCCESSION OF OPERATORS SO-5 <br /> 47 TC 1/MAC <br /> ADMINISTRATIVE INFORMATION <br /> Permit Information <br /> Permit Number: M-1977-376 <br /> Operation Name: Canon Dolomite Quarry <br /> Permittee Information <br /> Contact Person: Daniel Tezak <br /> Company Name: Canon Dolomite Quarry, LLC <br /> Street Address: 205 Tunnel Dr. <br /> city: Canon City <br /> State. CO Zip: 81212 <br /> Phone: 719 ) 269-1173 <br /> Email (optional): <br /> Prospective Successor Information <br /> Contact Person: Neil Whitmer <br /> Company Name: Holcim-WCR, Inc. <br /> Street Address: 1687 Cole Blvd, Suite 300 <br /> city: Golden <br /> State: CO Zip: 80401 <br /> Phone: 914 )213-7859 <br /> Email (optional): neil.whitmer@holcim.com <br /> Office of Office of <br /> Mined Land Reclamation Denver-Grand Junction-Durango Active and <br /> Inactive Mines <br />