2004-01-08_REVISION - M1984001

• Permit No: M1984001
• IBM Index Class Name: Revision
• Doc Date: 1/8/2004
• Doc Name: Request for Corrections to SO Appl.
• From: DMG
• To: J and M Schmahl
• Type & Sequence: SO2
• Media Type: D
• Archive: No

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II. ADMINISTRATIVE INFORMATION:
1'. Permit Number:
-~F 2. Operation Name:
3. Current Permitted Operator:
Contact Person:
~ompany Name:
Street:
City:
State:
Area Code:
4. Successor Operator:
Contact Person:
Company Name:
Street:
city:
State:
Area Code:
M-198-~.~
Su~~~ ~f
/y1,~~5'R /t'o~ /~' C~-
3Sya ~'~ ~/o ~ .
~ y~~77B//,, ~ Zip Code: ~}g~
%v Telephone: ~ //
IRS Tas ID No. or Social Security No.: ~~'a~g~~
5. Application Fee: $100.00 for Hazd Rock operations; $125.00 for Construction Materials
operations
Make check payable to the Division of Minerals and Geology
(~~~7 Zip~7C-ode: _
7 /y Telephone: %a~ ~G~~~