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a. <br />14. <br />Correspondence Information: <br />APPLICANT/OPERATOR (name, address, and phone of name to be toed on permit) <br />Contaet'sName: PG7~CI^ /, l~/eg,~i~vr~a1 Title:_y/ee ~/C5%e/rir~ <br />Company Name: ~/~e .SI4rGro ~ ~i>e ~6, y i>~ ~dsatai~a~ o ~ /l'/CSa lacy ~/~ <br /> <br />Street: <br />7 Z 7 3 i <br />~;Vlr /~Oaa/ <br />City: ~ras/fa/ ~/.ec Til}H <br /> <br />State: CD Zip Code: R/SOS <br />Telephone Number: (r/ZO ) - 243 - 5t %00 <br />Fax Number c 970 ~ - .Z4 3 - s/9 ¢ <br />PERMITTING CONTACT (if different from applicant/operatorabpve) <br />Contact's Name: G/tq LPw/ G.~.' Title: ~/ii7eii~o ~ <br />Company Name: Gi'rc> Lewio.~i C//Jd ~i50Gio~~s <br />Street: //~i ~f / ~ n,~ ~., /.(~ar~~~v, t!'f- <br />City: ~p/~~ii^ <br />Statef" CQ Zip Code: Y3O/ 38 <br />Telephone Number: i~ - 3 ~ - S/ `/~ <br />FaY Number: {{ 3d3 )) - .3 ~ - `0 9~4- <br />INSPECTION CONTACT //~~ .~J <br />Contact's Nam..: ,Oi // ~r~G W _ Tide: ~rGg ~7o~s~ ev <br />~~ i <br />Company Name: /JI~G.~5~/e Sl~/G~i^2r(O__~i9G .Lie Udi~/.Li~ies a~/yC~ lwu~f~ <br />Street: 2734L ~T w7 ~ ~ 24 <br />city: /~ ~- /c <br />State: C-/J Zip Code: fI~~SO <br />Telephone Number: (970 1- /~ 2S- X73 ~ <br />Fax Number: ! 970 1- 625- 5~0 <br />CC: STATE OR FIDERAL LANDOWNER (if anyl <br />City: <br />Stale: <br />Telephone Number: ~~ - <br />Agency: <br />Street: <br />Zip Code: <br />CC: STATE OR FEDERAL LANDOWNER (if anyl <br />Telephone Number: ~~ - R E ~. E A <br />Agency: <br />Street: <br />City: <br />State: <br />Zip Code: <br />JUN 1 0 2002 <br />Division of Minerals and Geology <br />