PERMFILE122360

• Permit No: M2004084
• IBM Index Class Name: Permit File
• Doc Date: 1/13/2005
• Doc Name: New Appl Form
• From: MVR Resource Inc.
• To: DMG
• Media Type: D
• Archive: No

-3-
14.~ot~q~~ondemx I~ormatbn:
APPLICANT/OPERATOR (name, address, avd phone o£name to be used on pemtit)
Contact's Name: Ed Benson Title: Owner/Partner
CompenyName: Benson Brothers
StreeUP.O. Box: 21240 Austin Road P.O. Box:
City: Austin
Smote; Colorado Zip Code: 81410
Telephone Number:
Fax Number:
Contact's Name:
Company Name:
Strcet/P.o. Box:
City:
State:
Telephone Number.
Fax Number:
( 970 ) _ 835-3128
( )-
(if different from applicairt/operator above)
Michael L. Ripp Title: Consultant
MVR Resources Inc.
3990 Old Wagon Road p,O, ~; 54
Colorado
Zip Cade: 81416
( 970 1- 874-5127
{ 970 ). 874-3161
C~tact'sName: Ed Benson Title: OwnerlPartner
Company Name: Benson Brothers

Street/P.O. Box: 21240 Austin Road P.O. Box:
C;t}c Austin

State: Colorado Z{p Code: 81410

Telephone Number. (^,970 ) _ 835-3128
Fax Number: ( ) -
CC: STATE OR FEDERA L LANDOWNER (if atrv)

Agency:

Street

City:

State: Zip Cade:

Telephone Number. ( 1-

CC: STATE OR FEDERA L LANDOWNER (if am)

Agency:

Street

City:

State: Zip Code:
Teleplmae Number