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_ <br />I1. <br />ADMIMSTRATIVE INFOIL'NATTON: <br />1. Permit Number. <br />2. Operation Name: <br />3. Current Permitted Operator. <br />Coated Person: <br />Company Name: <br />Street: <br />city. <br />StSte: <br />Anx Code: <br />4. Successor Ocerator: <br />Contact Person: <br />CornpanyNamc: <br />Strxt <br />City. <br />State: <br />Area Code: <br />IRS TaY ID No. or Social Security No.: <br />Gary J. Tuttle <br />(~tS7><~N i'Ylt7B11E 130~Jt-~, /NC . <br />1590 W. 12th Street <br />Denver <br />CO Zip Code: 80204 <br />303 TCICphOIIe: 657-4123 <br />Gary J. Tuttle <br />Iafarge West, Inc. <br />1590 W. 12th Avenue <br />Denver <br />co Zip Code: 80204 <br />303 Telephone: 657-4123 <br />h1- JR~t~-v~o <br />N~LSD N ~ /T <br />5. ApplicaAon Fee: $100.00 for Hard Rock operations; $125.00 for Construction Materials <br />operations <br />Make chock payable to the Division of Minerals and Geology <br />