REV105226

• Permit No: M1977567
• IBM Index Class Name: Revision
• Doc Date: 8/20/2001
• Doc Name: TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS APPLICATION FORM
• Type & Sequence: SO1
• Media Type: D
• Archive: No

II. ADMIMSTRATiVE INFORM1tATiON:
I. Permit Number:
2. Qperation Name:
3. Current Permitted Operator:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
4. Successor Operator:
~ REI~EIV ED
pl1G 2 0 2001
- 2 • Geolo9Y
pivision of Minerals and
M-1977-567
Airport Pit (Saguacl~e County)
John T. OnKefuR
SaRuache County
PO Box 476
SaRuache
Colorado Zip Caie: 81149
719 Telephone: [phone]
Contact Person: Joe Alexander
Company Name: / 6' / Lft -n ~ ~ - G iv- 7~Le
Street: PO Box 163
City: SaRuache
Stale: Colorado Zip Codc:: 81149
Area Code: 7/ 9 Telephone: l.6-S" - o~ o2L 3
IRS Tai ID No. or Social Security No.: B a a - S~ - 9G /d-
5. AoalicationFee: $100.00 for Hazd Rock operations; $125.00 for Construction Materials
operations
Make check payable to the Division of Minerals and Geology