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2003-01-09_REVISION - M1984001
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2003-01-09_REVISION - M1984001
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Entry Properties
Last modified
6/16/2021 2:06:54 PM
Creation date
11/21/2007 9:13:58 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1984001
IBM Index Class Name
Revision
Doc Date
1/9/2003
Doc Name
SO Application Form
From
Wayne Wright
To
DMG
Type & Sequence
SO1
Media Type
D
Archive
No
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9- <br />R. ADMINISTRATIVE INFORMATION: <br />1. Permit Number: <br />2. Operation Name: <br />3. Current Permitted Operator: <br />Contact Person: <br />Company Name: <br />Zn~STR IRL Ft i3~r~ G.,~ - <br />Ve~T~RS LLG <br />SoHAI .~. ~ Ms~~ILyn/ ,5~~}A1/}~L <br />street: 3 FS 9- 2 ~ R p <br />City: p ~ LI S .4 ,pY- <br />State: G O Zip Code: ~ ~ L~ <br />Area Code: 4 7 D Telephone: '~" ~0 4 " ~f I ~O ~ <br />4. Successor Operator: <br />Contact Person: <br />Company Name <br />street. X1-1 Y ,`i ~{-~ Pt 17 <br />City: PAL! /4 U ~~ D <br />State: Zip Code: ~~(~ <br />Area Code: q,~ Telephone: y'".~j'y"- b,.Cj~(o <br />IRS Tae ID No. or Social Security No.: .ri Cn ~ •- `j ~ - ~} ~ ['~ <br />5. AnalicationFee: $100.00 for Hazd Rock operations; $125.00 for Construction Materials <br />operations <br />Make check payable to the Division of Minerals and Geology <br />
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