REV103912

• Permit No: M1987171
• IBM Index Class Name: Revision
• Doc Date: 12/9/1999
• Doc Name: TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS APPLICATION FORM
• Type & Sequence: SO1
• Media Type: D
• Archive: No

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I1. ADMINISTRATIVE INFORMATION:
l . Permit Number:
2. Operation Name:
M-87-171
Fountain Colonv Pit
3. Current Permitted Ocerator:
Contact Person:
Company Name: -
Street:
City:
State:
Area Code:
4. Successor Operator.
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
IRS Tax ID No. or Social Security No.:
Ray Marshall
Fountain Cnl nnv Tnvnetm@IIr°
31 North Tea nn
Colorado Springs
Colorado Zip Code: 80903
719 Telephone: aa4_agp0
Tony Collins
Rievit Western CO
7926 S. Platte Canyon Road
Littleton
Colorado Zip Code: 80128
303 Telephone: [phone]

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