2016-10-17_REVISION - M1994053

• Permit No: M1994053
• IBM Index Class Name: REVISION
• Doc Date: 10/17/2016
• Doc Name: Request For Succession Of Operator
• From: Base Products
• To: DRMS
• Type & Sequence: SO1
• Email Name: DMC
• Email Name: GRM
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF RECLAMATION,MINING AND SAFETY
Department of Natural Resources
1313 Sherman St.,Room 215 C O L O RA D O
Denver,Colorado 80203 ]DIVISION o f
RECLAMATION
Phone:[phone] MINING
FAX:[phone] —&—
SAF ETY
APPLICATION FORM
FOR TRANSFER OF MINERAL PERMIT AND
SUCCESSION OF OPERATORS
ADMINISTRATIVE INFORMATION
Permit InformationG� �
Permit Number: fM- i qq 14- QS_?) RECEIVED
Operation Name: Z cL gyp, PYna ujtS G v its Q A RA 1 ^^T 17 20 16
Permittee Information
—� Ij'v's;0H(if Reclamdon
Contact Person: � on`I :7, �npcce��inZ Mining&Safety
Company Name: ? PYYa�Is c k
Street Address:
City: Moyl
State: C,_0�MCC, Zip:
Phone: ct01
Email(optional):
Prospective Successor Information
Contact Person: a Avll-
Colfi E r
mpany Name:
Street Address: c)C,(0 c) y u3 u 1 cc ()
City: � y�� �--V-o S� �✓
State: L�dYC,CA c-, Zip: � ) d
Phone:-( 9-7O ) - M I Dln
Email(optional):
C/0loou���+ �sa� k"VA '61 �Al
Office of Office of
Mined Land Reclamation Denver•Grand Junction•Durango Active and
Inactive Mines