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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St..Room 215 tR;ECLAMATION <br /> RA D F <br /> SO-1 ION OF <br /> Denver,Colorado 80203 ERR/MAC Phone:(303)866-3567 NING <br /> FAX:(303)832-8106 SAFETY <br /> APPLICATION FORM <br /> FOR TRANSFER OF MINERAL PERMIT AND <br /> k-1 <br /> SUCCESS.TON OF OPER AT(lT' <br /> CiP. RECEIVED <br /> ADMINISTRATIVE INFORMATION JAN 0 8 2024 <br /> Permit Information ColoradMDingand Werimatlon, <br /> Permit Number: M-2023-004 <br /> operation Name: Bronco Plains 11 Wind Farm, West Pit <br /> Permittee Information <br /> Contact Person: Maxwell Ammann <br /> Company Name: Blattner Energy, LLC <br /> Street Address: 392 County Road 50 <br /> City: Avon <br /> State: M N Zip: 56310 <br /> Phone: ( 350 ] 247-9793 <br /> Email (optional): MAmmann@blattnerenergy.com <br /> Prospective Successor Information <br /> Contact Person: Marcy Brossman <br /> company Name: Cheyenne County <br /> Street Address: P.O. Box 567 <br /> city: Cheyenne Wells <br /> State: Colorado Zip: 80810 <br /> Phone: ( 719 ] 767_5872 <br /> Email (optional): ccadmin@rebeltec.net <br /> Office of office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Active and <br /> Inactive Mines <br />