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2- <br />II. ADMIlYISTRATiVEIlVFORMATtON: <br />1. Permit Number: <br />Nl - ~ 9 9 4- - ~- \ ~ '-t <br />2. Ope~ation Name: <br />3. Current Perm~i fled Ocerator. <br /> <br />CoatactPetson: ~~ae"" A' 5-ca~ <br />iTC+G E~1J~iLOy ML^~1~'nL C.O b¢f9G \~c <br />Compan}+Name: <br />Street 9~R-S 5,~..sv..,~ Ca,-<o~ '1).z.~~ <br />City: 80 ~,~.~~~ <br />State: Co~oRA~a Zip Code: ao'3e~2 <br />Area Code: 30 3 Telephone: ~ s ~ - ~ 9 8 S <br />4. Snecesaor Ocerator <br />1/~0"...- ~o~c..~c V~.~ :.,was ~.~c <br />Company Name: <br />Sued: °145 Sv~S~+.„~ G„~~~.~ 'De,~~ <br />Clty: ~ O U ~--9 ~2 <br />State: ~o ~o e > v o Zip Cade: ~ 0 30 2 <br />p~Code: ~aa3 Telephone: A-43 - X969 <br />IItS Tax ID Na. ~ Social Security No.: ~ 4- - 3 ~ 9 41 5 9 <br />5. AnulicaNou Fee: $100.00 for Hard Rock operations; $125.00 for Construction Materials operations <br />Make check payable to the Division of Minerals and Geology <br />