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<br />iJEPARTMENT OF NATURAL RESOURCES <br />Davitl H. Getchea. Executive Director <br />MINED LAND RECLAMATIO(~ DIVISION <br />DAVID C. SHELTON, Dlroctor <br />I RicnarC D. Lamm <br />Govamor ~~ REGULAR (112) PERMIT <br />~/~~~ APPLICATION FORM <br />~~ ~~5 <br />o~~~o MP.~~pN <br />~e <br />rprlication for Mi~l~ff~~amation Permit, Pursuant to C.R.S. 1973, 34-32-101, <br />at tag, as a ~~tUl 027 ?a <br />9~\~~e~oA~• ~, /YI - 5~ 5 ~ 18 ~ c or.a ~; S i 8 I ~ 1. F~ X U . t <br />Type of Print Clearly) <br />Southwest Ready-mix <br />]. Name of Operation <br />(pit, mine or site name) <br />2. game of Applicant/Operator I Southwest Readv-Mix Inc. <br />(name io be used on permit) <br />3. <br />Y <br />4. <br />Address and Phone Number of <br />Local Office <br />Address and Phone Number of <br />117 White Pine <br />Alamosa, CO 81101 589-5105 <br />117 White Pine <br /> General Office I Alamosa,CO 81101 589-5105 <br />5. Name and Phone Number of Person John T. Ungefug <br /> Staff Members Should Contact I 5~f-5105 <br />6. Parent Corporation, If Any <br /> (include name and address) ~ <br />7. Owner(s) of Record of Affected <br /> Land (surface area) I Rich and Company <br /> (if more than two, list in <br /> EXHIBIT P) <br />8. Owner(s) of Substance to be <br /> Mined (if more than two, list I Rich and Company <br /> in EXHIBIT P) <br />Rich Pit <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (30'x) 866.3567 <br />