REV88442

• Permit No: M1983090
• IBM Index Class Name: Revision
• Doc Date: 5/3/2000
• Doc Name: TRANSFER OF PERMIT & SUCCESSION OF OPERATORS APPLICATION FORM
• Type & Sequence: SO4
• Media Type: D
• Archive: No

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II. ADhIIIVISTRATIVE INFORMATION:
1. Permit Number:
2. Operation Name:
M-1983-090
LaPoudre Resource
3. Current Permitted Operator:
Contact Person:
Company Name: -
Street.
City:
State:
Area Code:
4. Successor Operator:
Contact Petson:
Company Name:
Street:
Ciry:
State:
Area Code:
QtS Tax ID No. or Social Security No.:
Jeff Gregg, Vice President
Hall-Irwin Construction Company
3026 4th Avenue
Greel
CO Zip Code: 80631
970 Telephone: [phone]
Jeff Gregg, 'lice President
Hall-Irwin Corporation
3026 4th Avenue
Greeley
CO Zip Code: 80631
970 Telephone: [phone]

5. AooGcation Fee: $100.00
Make check payable to the Division of Minerals and Geology