2006-08-24_REVISION - M1994114

• Permit No: M1994114
• IBM Index Class Name: Revision
• Doc Date: 8/24/2006
• Doc Name: Tsf of Permit and S.O. application
• From: Kagan & Son LLC
• To: DRMS
• Type & Sequence: SL1
• Media Type: D
• Archive: No

2-
II. gDMIIdISTRATIVE7NFOR,MA17ON:
]. Permit Number:
2. Operative Name:
3. Cnrreat Permitted Operator.
Cvetact Person:
-114
Kagan & Son South Pit
Arthur L. Nordvke
Ccn»pmy Name:
Strew:
City:
Stan:
Atea Code:
4. Sttaeator Otwxtor.
Contact Pcsw:
Compmry Name:
Street:
City:
State:
Area Code:
IRS Tax ID No. or Social Septrity No.:
Norrl~~p constructs on, ~ nc.
57798 Hwy 69 South, P.O. Box 29
Westcliffe
Colorado Zip Code: 81252
719 Telephone: [phone]
Andrew Kagan and_Rebecca M. Kagan
Kagan & Son, L.L.C.
555 Ernest Ave.
Westcliffe
Colorado 2+pC~e: 81252
71 9 Telephwc: 7 8 3- 2 8 6 7

5. Aeuliritbn Fee: 5100.00 fur Flard Rock operations; SI25.00 for Cattstrrrctiw Materials ~aliws
Make deck payable to the Divisive of MmeraLs and (3eok~gy