PERMFILE116102

• Permit No: M2006053
• IBM Index Class Name: Permit File
• Doc Date: 6/9/2006
• Doc Name: Construction Materials Limited Impact 110 Operation Reclamation Permit Application Form
• From: DMG
• To: Canyon Rim Stone
• Media Type: D
• Archive: No

2-

11. Corresnondence Informafion:
APPLICANTlOPERATOR (name, address, and phone of name to be used on permit}
ContacYsName: -E..Lose.n.ce-Jaekson_ :. ~,_:..~ Titte:mp,~er,F_manaeer---

CompanyName: ~ - ~- ~ - ~ ~ ~~

Streei/P.O. Box: 2 7 5 0 0 C t: 18 3 P.O. Box:
City: Y.ir? - .. ...
Stare: C ~ Zip Code: 810 4 9

Telephone Ntnnber: (71 9 )- 6 4 3- 5 4 5
Fax Number: (719 T_643-5435
PERMITTING CONTACT (if different from applicantlopemtor above)
ContacYsName: W. Jack Clark PhD Title member/inaaaRer
Company Name: Clark Minine:"Services LLC
StreeUP.O.Box; 6052 South Mewport Street p.O.Box:
City: Centennial
State: C O Zip Code: 8 0 1 1 1
Telephone Number: ( 3 0 3 1- 2 21 - 6 5 8 8
FaxNtmmber: ( 303 T_221-6588
INSPECTION CONTACT
ContacYsName: Everett Jackson Jr. Titteimember/manager
Company Name: Canyon Rim Stone LLC
Street/P.O. Box: 2 7 5 0 0 C B 18 3 P.O. Box:
City:
Kim
State: C 0 Zip Code: 810 4 9

Telepho~ Number: ( 1-

Fax Number:. ( I -
CC: STATE OR FEDERAL LANDOWNER (if anvT
Agency: NOT1': minerals owned by 1T. S. P,overnment. .&ee..
StreeT: -4 sale contract to be extablished
City: between Canyon R.im Stone LLC and BLPI

State; Zip Code:
Telephone Number: f ) -
CC: STATE OR FEDERAL LANDOWNER (if any
Agency:
Street:
City:
Smte:
Telephone Number: ( 1 -
Zip Code:
-3-