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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 RA D O <br /> DIVISION OF <br /> Denver,Colorado 80203 JJJ RECLAMATION <br /> I <br /> Phone:(303)866-3567 -_--- --� <br /> FAX:(303)832-8106 —SAFETY <br /> APPLICATION FORM 3 (I I I <br /> FOR TRANSFER OF MINERAL PERMIT AND <br /> SUCCESSION OF OPERATORS °' <br /> AfrV <br /> ADMINISTRATIVE INFORMATION <br /> Permit Information [ ' 7" <br /> Permit Number: M-2009-048 Ve ni^g �, <br /> MININGANDSAFETY <br /> Gunnison River Gravel Pits <br /> Operation Name; f <br /> Permittee Information <br /> Contact Person: Russel A Larsen c 3 i►Lim <br /> -si y'4 <br /> Company Name: Grand Junction Concrete Pipe Co. V "'d <br /> 556 Struthers Ave. ea j-2�i i <br /> Street Address; — _ � <br /> city: Grand Junction <br /> State: CO Zip: 81501 <br /> Phone: �70 ) 242-5370 ✓ rv"� s i% l' �`� <br /> Email(optional): <br /> J�,� ,� 3 <br /> Prospective Successor Information <br /> Contact Person: Mark Gardner AIa'�l <br /> Company Name: Whitewater Building Materials Corp, a Colorado Corporation <br /> 940 South 10th Street <br /> Street Address: <br /> city: Grand Junction <br /> State: CO Zip: 81501 <br /> Phone: (970 )242-7538 <br /> Email(optional): mark@whitewater.construction <br /> v l h a-0 iD CA C-5 b <br /> Office of Office of <br /> Mined Land Reclamation Denver-Grand Junction•Durango Active and <br /> Inactive Mines <br />