Laserfiche WebLink
~. <br />II. ADMIMSTRATIVE INFORMATION: <br />1. Permit Number: <br />~-200-05`~ <br />2. Operation Name: <br />3. Current Permitted Ocerator: <br />Contact Person: <br />Company Name: rih~iivn ~Qgq~_(~rv.~O~u~f ' ~' <br />Street: ~ 0, al9(/c~ ~/~ <br />City: i ~ <br />State: f `.s: Zip Code: 8~ 12.3~~ <br />Area Code: 7l7 Telephone: 9 ~ ~- ~ ~~~ <br />4. Successor Ocerator: <br />Contact Person: ~®"Ce- 11' (3' (~'~a- <br />Company Name: <br />stet: 1 i~ .so FDA 2S.S- <br />City: _ - . ~~ ~ - <br />state: ~°,~. Zip Code: ~!1 ~D <br />Area Code: 7f ~ - Telephone: ?. 7 ~ - ~ d 7~ <br />IRS TaY ID No. or Social Security No.: ~,~ .~~ - ~~ <br />5. Aoolication Fee: 5100.00 for Hard Rock operations; $125.00 for Construction Materials <br />Opera[IOIIS <br />Make check payable to the Division of Minerals and Geology <br />