2000-04-10_REVISION - M1978208

• Permit No: M1978208
• IBM Index Class Name: Revision
• Doc Date: 4/10/2000
• Doc Name: TRANSFER OF MINERAL RECLAMATION PERMIT & SUCCESSION OF OPERATORS APPLICATION PACKAGE
• Type & Sequence: SO1
• Media Type: D
• Archive: No

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II. ADMIIVISTRATIVElNFORMATION:
1. Permit Number:
2. Operation Name:
3. Current Pernutted Operator:
Contact Person:
Company Name:
Street:
Clty:
State:
Area Code: -
4. Successor Operator:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
IRS Tax ID No. or Social Security No.:

46R Smith rhiAl P~ St rc.ot
Lakewood
Colora:9o Zip Codes 80226
303 Telephone: [phone]
William S. Peterson
,'~soen Ente.-prises
12383 1•iamblee Vallev Road
olorado Zip Code: R04R'2
303 Telephone: [phone]
5. Application Fee: $100.00
Make check payable to the Division of Minerals and Geology
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