2006-10-08_REVISION - M1984001

• Permit No: M1984001
• IBM Index Class Name: Revision
• Doc Date: 10/8/2006
• Doc Name: Tsf of Permit and S.O. application
• From: Parkerson Brothers, LLC
• To: DRMS
• Type & Sequence: SO3
• Media Type: D
• Archive: No

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IL AUMINISTI2ATIVE 4YFORMATION:
1. Pemtit Number:
M - 19Y~`-- ool
2. Operation Name:
3. Current Permitted Ocerator:
5v2FAC_6 'SOUC Ptr
Contact Person: t-t,~ N t, S P E Y
Si:551u^e Q ~
Company Name: `
unlAWG6P V ~n/'1URES ~--LG
Street: 3n5 Socl~r~ lie. Unirr Q-~
CILy: ~ISLL V RI ~ E
state: Cuwrty+~o zip code: ~31'i35
Area Code: o1~U Telephone: ~a~t'C93~c~
4. Successor Operator:
Contact Person:
Company Name:
Street:
city:
State:
Area Codc:
IRS Tax (D No. or Social Security No.:
A Ian ~ar ~tErsOYI
i3rp.F hers
Parke~sa~ _ - LLC

7lo s 15i-h St
Grand Junction
C ~ 'Lip Code: ~ 15 a ~
~ 70 'Celephone: ~? y .~ - 813 ~}

5. Application Fee: $100.00 for Hard Rock operations; $12100 for Constmction Materials operations
Make check payable to the Division of Reclamation, Mining and Safety