PERMFILE61769

• Permit No: M2006009
• IBM Index Class Name: Permit File
• Doc Date: 1/30/2006
• Doc Name: 112 Reclamation Permit Application
• From: Mesa Sandstone LLC
• To: DMG
• Media Type: D
• Archive: No

-3-
11. S'~eeesoondmce Istornadon:
ePPL[CANTlOPERATOR (na¢ue, address, and place of mme to be used on permit)
Contest's Name: DAREN STONE Title: INITIAL MANA(;ER
Company Nerve: MESA 3AZITfl9TC11TE
StreeUP.O. Box: 24800 CGUNTY ROAD 'n. P.O. Box:
City: GOBTEZ
State: --COL~IRADD Zip Code: $131
Telephone Number:
Fax Number: ( 870 1 • 565-2603 (Call tlrst before sendlna FAX1
~IITfINQ CONTACT (if diRerem from applicant/operator above)
CantacPs Nerve; DOUGLAS L. CONGER Title: GEOLOGIST
Compmy Name: GEO7AdICAL 9ERViCEB
StrcetlP.O. Box: 711 HARTMAN ROAD P:O. Box:
City: CQ~TEZ
State: COLOReDA Zip Code: 81321
Telephone Number. { 870 ) - 588- 8384
Fax Number: { 970 l . 585- 8394 (Call first treto ro sendlna FAXI
jj33SPFt<,TION CONTACT
Contect'sNetne: WILLIAM K. GOODE
Title: INITIAL MANAGER
Compatry Name: MESA l31iNaBR'ONE
StmeVP.O. Box: P.O. Box: 22e
City: CORTEZ
State: COLO ADO Zip Code: g~2~ _~
Telephone Numbs; { 870 ) - 885-1187
Fex Number: L 870 ~ . 885-2803
CC: STATE OR FEDERAL LANDOWNER (if aml
ABmcY:
Strout:
City:
State:
Telepham Number. f
CC: STATE OR FEDERAL LANDOWNER (if am)
Ageaiy:
Street:
City:
State:
Telephone Number: { 1.
Zip Codc:
Cow:
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