REV97207

• Permit No: M1980228
• IBM Index Class Name: Revision
• Doc Date: 2/6/1995
• Doc Name: TRANSFER OF PERMIT & SUCCESSION OF OPERATORS APPLICATION FORM
• Type & Sequence: SO2
• Media Type: D
• Archive: No

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II. ADMINISTRATIVE INFORMATION:
1. Permit Number:
2. Operation Name:
3. Current Permitted Operator:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
M-80-228
Triangle One Pit
Kenneth D. Smith
Smithco Construction & Excavation
Box 1452
Pagosa Sorines
Colorado Zip Code: 81147
303 Telephone: [phone] or 264-4210
4. Successor Operator:
ContdCt Person: Ronald W, Petti rew
Company Ndme: Durango Construction, Inc.
Street: Box 2707
City: Durango
State: Colorado Zip Code: 81302
Area Code: (303 Telephone: [phone]
IRS Tax ID No. or Social Security No.:
5. Application Fee: $100.00
Make check payable to the Division of Minerals and Geology