REV04151

• Permit No: M1977247
• IBM Index Class Name: Revision
• Doc Date: 10/21/1996
• Doc Name: TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS APPLICATION FORM
• Type & Sequence: SO2
• Media Type: D
• Archive: No

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ADMINISTRATIVE INFORMATION:
1. Permit Number:
2. Operation Name:
3. Current Permitted Operator:
Contact Person:
Company Name:
Street:
city:
State:
Area Code:
4. $UCGeSSOr QperatOr:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
IRS Tax ID No.
5. Application Fee

<'es~t.oaLE ~`lPs~nM ~~N~.
DO ~TAY2_ Czy PSV.M
~N~z~ s.k~
N~u~.~TE ,~N~
~ogyc 3~
C°Co Pr~l
C~ Zip Code: B~Z2.3
~~~ Telephone: °142-4~'~g
Alan D. Parker
G-P Gypsum Corporation
133 Peachtree Street NE
Atlanta, GA 30303
Zip Code:
404
or Social Security No.:
5100.00
Telephone: fis~-SF~i
Make check payable to the Division of Minerals and Geology
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