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z. <br />a. ADMRYfSTRATIV& RVFORMATI[oN: <br />I. re®itNmober: M ~- ry92 - ~~ ~ <br />2. Opaatim Name: ll (M'rlQ. L,BC/~/2t'M <br />3. Cvreett Peradtted_QQadt4r. <br />Ca~erre~: ~u ~ ~ i J~.. <br />Campmy Name: ~~ AnM Ll.. ~ ~'~/ <br />saeec b <br />r~~/ <br />sue: c f~ ~ Caae: 8 o Zs8 <br />Area Cade: Telephone: ~ 7b ' ~32 ~ S / ~8 <br />4. Snaeasor Ooentor• n <br />CantrtPecsw: rfl~'l; ICer ~dG~xYl56rl <br />Compmyxame: Ori,~p,~~n ~Yt~S~~5nrt5 Foed~nf <br />s~ ~~oX 32-I - ~'o +Zd ~'R 3`/340 <br />8058 <br />Sbt~ -7Cl) Zip Code: ~7~8 <br />,lsea Cade: qQQ 1I111 ~ Tabphone: .3 ~. - ~ r13'1 <br />IRS Tax ID No. or Social Security No.: ()`t ~ ~ ~ ~ ~ ~ <br />5. Y,Fffi: 5100.00 for Had Rock operations; 5125.00 far Conehuction Meteriala openlioos <br />Make check payabb to the Division of Miaetals and Geology <br />