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I. <br />~. <br />ADMINISTRATIV$ IiVFOIL'~IATTON: <br />i. Permit Number: ~ "~ 1 ~ ~ 3 ~O g~ <br />2. Operation Name: DBU(t-L~l~i Gpu.VTY Sfltl,/L~~Aljy~"Z <br />3. Current Permitted Oaerator. <br />Contact Person: .TG ~ E K ~L C E; lQ <br />Compa~Name: „~ SNl~ft'L I ~fI1/],,rJ(,- C~~,~~J.1/~ <br />Street: I4`~D2 eUE; S~ ~'~fT~1/E <br />city rr ~ ~ n r.~t,L <br />State: G O C n IFfI /~/7 Zip Code: ~Q~@~. <br />Area Code: ~ Telephone: 2 7 `fi --~ ~~ // <br />4. Successor Ocerator: <br />Contact Person: :'f~,~~, /t'L l `i ff E%/l~ <br />Company Name: DF'C~IPt L/~}-S C, 'O~ JAti'fI £+~(.~L?LLB <br />Strcet: S 3 G© Scf,.tJS-E~ ~{ /~" <br />City. G- ~ '~T L F' ~ r1/ <br />Slate: B(_if l4RAl~/~ Zip Code: --~-L~- <br />Area Code ~~ Telephone: 7 `n37~ ~ ©1 <br />IRS Tae ID No. or Social Security No.: ~!2~ ^ ~~D ~~" <br />~. Application Fee: $100.00 for Hard Rock operations; $125.00 for Construction Materials <br />operations <br />Make check payable to the Division of Minerals and Geology <br />