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

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11. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: -~F-1.o.r.e.nce,:,Jackson - _ Title:mPtahe hmanases--
Company Name: "" ~ ~ ~ '~

StreeUP.O. Box: 2 7 5 0 0 r, n. 1 8 3 P.O. Box:

Ciry: P.ir• _

Slate: C O Zip Code; 8 1 0 4 9

Telephone Nmnber: 17 1 9 )- 6 4 3- 5 4 '3 k

Fax Number: (719 1.643-5435
PERMITTING CONTACT (if different from appiicant/opemtor above)
Contact's Name: ?•7. Jack Clark PhD Tile:member/manager
Company Name: Clartc Minine"SPrvices i i ('
Street/P.O.Box: 6052 South PTewport Street p,O.Box:

City: Centennial
State: C O Zip Code: 8 0 1 1 1
Telephone Ntmber: 1 3 0 3 )- 2 21- 6 5 8 8
FaxNttmber. ( 303 1.221-6588

INSPECTION CONTACT'
Contac['sName; Everett Jackson Jr. Title member/manager
Company Name: Canyon Rim Stone LLC
Street/P.O. Box: 2 7 5 0 0 C R 18 3 Y.O. Box:
City: K i m
State: C O Zip Code: 8 10 4 9

Telephone Number: I ) -

Fax Number: ( ) -

CC STATE OR FEDERAL LANDOWNER (if anvl
Agency: DTOTF: minerals owned by [f.5. 8overnment. ~6.C-f.

Street -~ sale cont ract to he extablished
City; between Canyon Rim Stone LLC and BL1[

State: Zip Code:

Telephone Ntnnbtr: ( 1 -

CC: STATE. OR FEDERAL LANDOWNER (if anv)
Agency:

Street:

Citv:

Stale: Zip Code:

Telephone Nwnber: ( 1 -
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