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"�C\ , , <br />STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources ! t <br />1313 Sherman St., Room 215 COLORADO <br />A I V I S 1 O N O F <br />Denver, Colorado 80203 50$3 RECLAMATION <br />Phone: (303) 866 -3567 MINING <br />FAX: (303) 832 -8106 <br />SAFETY <br />APPLICATION FORM <br />FOR TRANSFER OF MINERAL PERMIT AND <br />SUCCESSION OF OPERATORS <br />ADMINISTRATIVE INFORMATION <br />FEB 0' <br />[. ;vision of Peci ;imation, <br />Permit Information REc <br />Mtn'li &Safety <br />Permit Number: M- 1990 -144 ,e/V <br />Operation Name: Boone - Fillmore Pit JA 9 <br />0-41 <br />Permittee Information lMSNjNGRFC(�,q�� <br />Contact Person: Steve Brown �5, <br />ph` <br />Company Name: Lafarge West, Inc. <br />Street Address: 10170 Church Ranch Way, Suite 200 <br />2-ii <br />city: Westminster <br />(,g -VA6 <br />State: Colorado Zip: 80021 -0021 <br />Phone: X03 ) 657 -4123 <br />Email (optional): <br />Prospective Successor Information <br />Contact Person: Ron Fillmore <br />Company � Lewis Fillmore <br />Na <br />, <br />Street Address: P.O. Box 258 <br />city: Boone <br />State: Colorado Zip: 81025 <br />Phone: (719 )568 -6712 <br />Email (optional): ronfill @hotmail.com <br />1 �u <br />Office of Office of <br />Mined land Reclamation Denver - Grand Junction • Durango Active and Y ar <br />Inactive Mines J� �! <br />