Laserfiche WebLink
STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> COLORADO <br /> 1313 Sherman St.,Room 215 $�-Z DIVISION o F <br /> Denver,Colorado 80203 ACY/TH M RECLAMATION <br /> MINING <br /> Phone:(303)866-3567 <br /> FAX:(303)832-8106 SAFETY <br /> APPLICATION FORM <br /> U— <br /> r--TVEDFOR TRANSFER IT AND <br /> SUCCESSION OF OPERATORS <br /> DIVISION OF RECLAMATION, <br /> MINING &SAFFTY-MINERALS ADMINISTRATIVE INFORMATION <br /> Permit Information C�G� <br /> Permit Number: <br /> Operation Name: AAI1e- giver <br /> Permittee Information <br /> Contact Person: <br /> Company Name: 47C" <br /> Street Address: <br /> City: <br /> State: co l/D r Zip: 2S <br /> Phone: <br /> Email(optional): j PSon !sa nCte je"rn . kle-T <br /> Prospective Successor Information <br /> Contact Person: CIO," <br /> Company Name: s lK Pc Street Address: <br /> City: <br /> State: 65,(o r oA Zip: g (6 y <br /> "hone: (61-76 <br /> ail(optional): fJpr�GCr�IC�'`T & amou •��''t <br /> Office of <br /> Denver•Grand Junction-Durango Active and <br />