Laserfiche WebLink
STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING AND SAFETY RECEIVED <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 APR 2 2�16 C O L O RA D O <br /> Denver,Colorado 80203 D I V I S I O N o f <br /> Phone-(303)866-3567 Cy �� RECLAMATION <br /> c MINING <br /> FAX:(303)832-8106 OF RW —&— <br /> &W$%%W I SAFETY <br /> APPLICATION FORM <br /> FOR TRANSFER OF MINERAL PERMIT AND <br /> SUCCESSION OF OPERATORS <br /> ADMINISTRATIVE INFORMATION <br /> Permit Information <br /> Permit Number: 1 01 Ci 3 - 0 3 J <br /> Operation Name: G- , Cite�r5tq�j Q 14, <br /> !'L� <br /> a <br /> x <br /> Permittee Information <br /> Contact Person: <br /> Company Name: /�vyL�c� Z— tr <br /> Street Address: <br /> City: <br /> Q State: Zip: <br /> Phone: (7/ <br /> Email (optional): )CP fl-) U=✓*1,gC(d fie` <br /> Prospective Successor Information <br /> Contact Person: �/��t' / L , �,° �� Cytk/f —� <br /> 0�nr�or �7 <br /> Company Name: tfo <br /> Street Address: 111 <br /> City: e �Z' a� 7,�✓i�'i�/S <br /> State: ��Q Zip: Qc)9 O <br /> Phone:1711 <br /> Email (optional): �v C' �i✓Ir>�C/P�� i7�i<;� ,,,L� <br /> Office of Office of <br /> Mined Land Reclamation Denver-Grand Junction-Durango Active and <br /> Inactive Mines <br />