2006-10-16_REVISION - M1983209

• Permit No: M1983209
• IBM Index Class Name: Revision
• Doc Date: 10/16/2006
• Doc Name: Tsf of Permit and S.O. application
• From: Frank Gilmore
• To: DRMS
• Type & Sequence: SO1
• Media Type: D
• Archive: No

2.
ii. ADy1L\'ISTRATIV$lNFORMATION:
I. Permi[ Number:
2. Operation Name:
M-1983-209
Benton Dawson Gravel
i
3. Corrent Permitted Ocerator:
Contact Person:
Congtany Name:
Street:
City:
State:
Area Code:
4. Suceessor Oceralor:
Contact Person:
Company Nana:
street:
c;ty:
State:
Area Codc:
IRS Tax iD No. or Social Security No.:
Jack Hawkins
Western Slope Construction Com
1221 Highway 50
Delta
CO zip code: 81416
970 Telephone: [phone]
Frank Gilmore
5998 Sawmill Mesa Road
Delta
CO Lip Code: 81416
970 Telephone: [phone]

5. A~plicatton Fee: $100.00 for Hard Rock operations; $125.00 for Construction Materials operations
Make check payable to the Division of Reclamation, Mining and Safety