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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 COLORADO <br />D I V I S I ON OF <br />Denver, Colorado 80203 RECLAMATION <br />Phone: {303} 2-810 67 i1 _ O� �0 � �jJ MINING <br />FAX: {303} 832-810fs V l�/� <br />SAFETY <br />APPLICATION FORM <br />FOR TRANSFER OF MINERAL PERMIT AND <br />SUCCESSION OF OPERATORS <br />ADMINISTRATIVE INFORMATION <br />Permit Information <br />RECEIVED <br />Permit Number: M-1998-058 APR 0 G 2017 <br />Operation Name: Tellier Gravel Pit Dlulsion of Reclamation, <br />Permittee Information Mining & safety <br />Contact Person: Brandon Martin <br />Company Name: Connell Resources, Inc. <br />Street Address: 7785 Highland Meadows Parkway, Suite 100 <br />city: Fort Collins <br />State: Colorado Zip: 80528 <br />llz.e <br />Phone: 970 223-3151 `/�' <br />� <br />Email (optional): bmartin@connellresources.com ✓VU � ,ten w" <br />Prospective Successor Information <br />t/ Cf cel �� y�lyd <br />Contact Person: Jason Burkey - _ � � 01 -dllI <br />Company Name: Oldcastle SW Group, Inc. dba United Companies , PVn& <br />V (V 01 <br />Street Address: 2273 River Road ° Pt '��( �KlJ <br />City: Grand Junction <br />State: Colorado <br />Zip: 81505 <br />Phone: 970 243-4900 <br />Email (optional): jburkey@oldcastie-materials.com <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Active and <br />Inactive Mines <br />