2012-06-06_REVISION - M1977081

• Permit No: M1977081
• IBM Index Class Name: REVISION
• Doc Date: 6/6/2012
• Doc Name: TRANSFER OF PERMIT & SUCCESSION OF OPERATORS APPLICATION
• From: LAFARGE WEST
• To: DRMS
• Type & Sequence: SO4
• Email Name: PSH
• Email Name: TAK
• Media Type: D
• Archive: No

II. ADMINISTRATIVE INFORMATION:
1. Permit Number:
2. Operation Name:
3. Current Permitted Operator:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
5. Application Fee:
-2-
M- 1977 -081
Greeley West Pit
$115.00 for Hard Rock operations; 144.00 for
Make check payable to the Division of Reclamation, Mining and Safety
Anne Johnson
Lafarge West, Inc.
10170 Church Ranch Way, #200
Westminster
Colorado Zip Code: 80021
303 Telephone: [phone]
4. Successor Operator:
Contact Person: Jim Hall
Company Name: City of Greeley
Street: 1100 10th Street, Suite 300
City: Greeley
State: Colorado Zip code: 80631
Area Code: �6 . Telephone: [phone]
IRS Tax ID No. or Social Security No.: 69 "' 4o DO 0 -54 3
nstruction Materials operations
PIA' SthBLt 3 dot