2006-10-18_REVISION - M1982015

• Permit No: M1982015
• IBM Index Class Name: Revision
• Doc Date: 10/18/2006
• Doc Name: Tsf of Min Reclam Permit and S.O. application
• From: Carma Bayshore LLC
• To: DRMS
• Type & Sequence: SO1
• Media Type: D
• Archive: No

II. AllMIA'ISTRATIVE IIYFOI2MATION:
I. Permit Number:
2. Operation Name:
3. Current Permitted Operator:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
2 - OCT 18 2QQ6
Division of Reclamation,
Mining and Safety
M-19-82-015
-.~t^cGn Lakes, 1'il'~nc~ ~~ Slurr~~ ~~~\\
Michael Siegrist
Siegrist Construction Company
$75 W_ 64th Avam~o
Denver
Colorado Zip Code: 80221
303 Telephone: [phone]
4. Successor Operator:
Contact Person;
Company Name:
Street:
City:
State:
Area Code:
IRS Tax ID No. or Social Security No.:
Tvler Packard
Cartna Bayshore LLC e~~
188 Inverness Dr. West, Ste. 150
ewood
Colorado Gip Code: 80112
303 'telephone: [phone]
5. Anplieation Fee: $100.00 for Hard Kock operations; $125.00 for Construction Materials operations
Make check payable to the Division of Reclamation, Mining and Safety