REV15515

• Permit No: M1977153
• IBM Index Class Name: Revision
• Doc Date: 1/21/2000
• Doc Name: TRANSFER OF PERMIT AND SUCCESSION OF POERATORS APPLICATION FORM
• Type & Sequence: SO1
• Media Type: D
• Archive: No

_,.
ADh1iMSTRATIVE INFORMATION:
I. Pemut Number:
2. Operation Name.
77-153
Hazeltine Pit
3. Current Permitted Operator:
Contact Person: Albert R. Frei
Company Name: Hazeltine Investment Association
Stree[:
City:
State:
Area Code:
4. Successor Operator:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
IRS Tax ID No, or Social Security No.:
Henderson
Colorado Zip Code: 80640
303 Telephone: [phone]
Albert P,. Frei
Albert Frei & Sons, Inc.
115 1 uriahton Road
Henderson
Colorado Zip Code: 80640

5. ARnlication Fee: $100.00
Make check payable to the Di~-ision oC Minerals and Geology