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<br />~. <br />II. AD(ViIMSTRATIVE INFORi~tATTON: <br />1. Permit Number: <br />Y~~-BS- 181 <br />2. Operation Name: <br />3. Current Permitted Operator: <br />Contact Person <br />Company Name: Kl ~ I l ()Yl ~l.~l,(a'J~,t.l <br />Street: ~ID,~ It1). ~A)t~ <br />city: ~~ l 'o ~ I i n~ <br />state: 0 ad zip code: osa <br />Area Code: ~R70~ Telephone: ~$ r~ - ~a i g <br />4. Successor Ocerator: <br />Contact Person: ~Q.V``YlI I P ~.l ~ ~ I C~Y~ <br />Company Name: ~ 1 I f lf1Y~ ~~'.Y~~iSCS 1.~-~. <br />sweet: ~o~ ~.~+.Lllox <br />city: .~-~ ~ Q,~ ~ i nt <br />State: /~OY~~U _ Zipff Code: <br />Area Code: `'l~o Telephone: ''1g~"~sc~ <br />IRS Ta~c ID No. or social Security No.: ~ ~ - ~ Sq r~(U 58 <br />~. Application Fee: $100.00 for Hard Rock operations; $125.00 for Construction Materials <br />operations <br />Make check payable to the Division of Murerals and Geology <br />