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. <br />~t <br />- ~ •• ~~I II~~I~~I~~~~~ ~~~ <br />STA'FE~~F COLv~v <br />MIINED LAND RECLAMATION DIVISION ~ .~..~ .~ ~~oF.to~D~, <br />Department of Natural Resources ~ ~_ ~ ~ f ve0$ <br />131:3 Sherman St., Room 215 <br />~,. >, <br />Denver, CO 80203 ~~D 9 1 q~~~ <br />303 866-3567 D 1 1 •• rl a e <br />FAX: 303 832.6106 <br />~IVIJ I(~I\ (~ Roy ROmer. <br />MINERALS & GEG~.. Fred q reanta. <br />Division Dirccror <br />TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS <br />APPLICATION FORM <br />The application for a Transfer ofrermit and Succession of Operators must contain three <br />(3) major parts: 1) an Application Form; 2> a Performance i+arran*.y (attached as part of <br />the P,pplication Package) bearing the original notarized signature of the Successor <br />Operator; and, 3) a replacement Financial Warranty (for the amount maintained by the <br />current permittee) provided by the Successor Operator, bearing an original notarized <br />signature. To expedite processing, please provide the information in the format and <br />order- described below. ~_~j, <br />I. EtDMINISTRATIVE INFORMATION <br />., <br />.. <br />Permit Number: <br />~/M-79-187 <br />Operation Name: <br />Current Permitted Operator: <br />Contact Person: <br />G. Clifford Clayton <br />COmpdny Name: Clavton Construction Co. <br />Street: 254 Byers l3o~f Z ~o <br />City: Fraser <br />State: Colorado Zip Code: 80442 <br />Area Code: 303 Telephone: 726-5366 <br />~i <br />c <br />Successor Operator: <br />Contact Person: Robert L. Morrow <br />Company Name: Morrow & sons, inc. <br />Street: ~~3s26 Cnnnty RnaA Sn <br />City: Fraser <br />State: Colorado Zip Code: 80442 <br />Area Code: 303 Telephone: 726-5624 <br />IRS Tax ID No. or Social Security No.: <br />Application Fee: $100.00 ~ i I- a 3-~~ <br />