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r' DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX: (303) 832 -8106 <br />woos v'13 <br />,,, a � Ap <br />RECEIVED <br />Cf� 3 12012 <br />Division. of Reclamation, <br />Mining & Safety <br />STATE OF COLORADO <br />COLORADO <br />D I V I S I ON O F <br />RECLAMATION <br />MINING <br />SAFETY <br />APPLICATION FORM <br />FOR TRANSFER OF MINERAL PERMIT AND 2,np <br />SUCCESSION OF OPERATORS <br />ADMINISTRATIVE INFORMATION <br />Permit Information <br />Permit Number: <br />M2008001 <br />Operation Name: <br />Blue Grass Gravel Pit <br />Permittee Information <br />Contact Person: <br />Robert D Beltramo V <br />Company Name: Beltramo Leasing LLC <br />Street Address: 4947 Alberta Falls Way <br />City: <br />Colorado Springs <br />State: Colorado <br />Zip: <br />Phone: (19 ) 544 -4744 <br />Email (optional): <br />Prospective Successor Information <br />Contact Person: John Sliman <br />80924 -0000 <br />Company Name: <br />Southwest Farms, Inc. <br />I� <br />Street Address: 214 39th Lane Hwy 96 East <br />Pueblo <br />ulty: <br />State: Colorado <br />Zip: <br />81006 <br />Phone: (719 )948 -2014 <br />Email (optional): <br />jfs57 @comcast.net <br />AF _ tl /a, / 13 <br />orw - CA <br />S oX') <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Active and <br />Inactive Mines <br />