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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY RECEIVED <br /> Department of Natural Resources <br /> OEC 1 3 2023 <br /> 1313 Sherman St.,Room 215 VIAL C� p IV IS I ON oF <br /> Denver,Colorado 80203 RECLAMATION <br /> Phone:(303)866-3567 Colorado Division of Reclamation, MINING <br /> FAX:(303)832-8106 <br /> Mining and Safety SAFETY <br /> APPLICATION FORM <br /> FOR TRANSFER OF MINERAL PERMIT AND <br /> SUCCESSION OF OPERATORS <br /> ADMINISTRATIVE INFORMATION <br /> Permit Information <br /> Permit Number: M v?O&6 .2 y <br /> Operation Name: wt'Z-a ✓'ane <br /> Permittee Information <br /> Contact Person: Ray or Stephanie Sikes <br /> Company Name: Carrizo Stone, LLC <br /> Street Address: 1425 County Road Q <br /> City: Pritchett <br /> State: Colorado Zip: 81064 <br /> Phone: T19 ) 980-1212 <br /> Email(optional): carrizostone@gmail.com <br /> Prospective Successor Information <br /> Contact Person: Russell Freeman <br /> Company Name: Carrizo Ranch Stone LLC <br /> Street Address: 11500 County Road 219.1 <br /> City: Pritchett <br /> State: Colorado Zip: 81064 <br /> Phone: (719 )338-5071 <br /> Email(optional): russell@thefreemanranch.com <br /> Office of <br /> Office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Active and <br /> Inactive Mines <br />