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2- <br />il. ADMINISTRATIVE INFORMATION: <br />1. Permit Number: <br />/~ ~bO~b~3 <br />2. Operation Name: <br />3. Current Peraetted Ocerator: <br />y~/~o * P;y-- <br />Cootact Person: ~ °L /' ~ ~. ~~~Q N SO Y~. <br />Corr~any Naroe: (/iq ~C D <br />street: x,00 S. /7r`~ST. ~ /~~X S.S~ <br />City: ~Oc. ~~. _ <br />state: ~ o zip Cue:-~/ 06 > <br />Area Code: 7/ 4 Telephatre: ~.J -L 7 y~i 1 <br />4. Successor Ocerator: <br />Contact Person: .SCp*fi U2I7/¢fil~A r <br />Company Name: Uo.9,~ji /e's ~2%~; h9 ~ /TOCis7~9/a~U`T _•F~ . <br />street: /D'f / /11. ,duirr.~ S i9de , <br />city: ,Da/+~A,S <br />state: 1.4`, zip Code: 790/~ q <br />Area Code: RQ ~ 'feiephone: 4l' J ^ 3 ~A <br />IRS Tax ID No. or Social Security No.: 7.! - ~~./~ b 3 y 4 9 <br />LIQ Ilbt ~ ~~~I~ ~ <br />5. Aodicatioo Fee: P $18E.00 for Hard Rock operations; $123110 for Construction Materials operatiots <br />Make check payable to the Division of Reclamatioq Mining std Safety <br />