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�m <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 <br />611Q1-7gf(I <br />STATE OF COLORADO <br />APPLICATION FORM <br />FOR TRANSFER OF MINERAL PERMIT AND <br />SUCCESSION OF OPERATORS <br />ADMINISTRATIVE INFORMATION <br />Permit Information <br />Permit Number: M-1977-484 <br />Operation Name: Gravel Pit No. 7 <br />Permittee Information <br />Contact Person: Rodney Robins <br />Company Name: Robins Redl MIX, LLC <br />Street address: 1269 Colorado Street <br />city: Springfield <br />State: CO <br />Phone: ( 719 <br />Email (optional): <br />523.4213 <br />Prospective Successor Information <br />Contact Person: Dean Ormiston <br />Tip: <br />81073 <br />COLORADO <br />DIVISION OF <br />RECLAMATION <br />MINING <br />SAFETY <br />RECEIVED <br />JUL 07 2015 <br />slon of Reclamation, <br />Mining & safety <br />ot�& Ilk,& <br />Company Name: Baca County <br />Street Address: 741 Main Street, Suite 1 <br />city: Springfield <br />r' <br />State: CO Zip: 81073 <br />Phone: (719 ) 523.6532 <br />Email (optional): dormiston@bacacountyco.gov <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Active and <br />Inactive Mines <br />