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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 C O L O R A D O <br /> Denver,Colorado 80203 DIVISION o e <br /> i RECLAMATION <br /> Phone:(303)866-3567 'b 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 8�3/,"-VL(o <br /> Permit Information <br /> Permit Number: M-1977-081 <br /> Operation Name: Greeley West Pit RECEIVED <br /> Permittee Information JUN 13 2016 <br /> Contact Person: Anastasia Frantsova <br /> tivlslon of Reclamation, <br /> Company Name: City of Greeley Mining&Safety <br /> Street Address: 1100 10th Street, Suite 300 <br /> city: Greeley <br /> State: Colorado Zip: 80631 <br /> Phone: ( 970 350-9806 <br /> ) <br /> Email (optional): a4 g-1t5iA,, <br /> Prospective Successor Information <br /> Contact Person: Bill McDowell <br /> company Name: Cottonwood Land and Farms, LLC <br /> Street Address: P.O. BOX 229 <br /> City: Boulder <br /> State: Colorado Zip: 80306 <br /> Phone: ( 303 ) 449-1441 <br /> Email (optional): �I Annual Fee/Report C due 8/16/20 6 <br /> J No Violations 6113" <br /> Office of Office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Active and <br /> Inactive Mines <br />