2007-08-03_REVISION - M1982020

• Permit No: M1982020
• IBM Index Class Name: Revision
• Doc Date: 8/3/2007
• Doc Name: Transfer of permit & succession of operators application form
• From: Elmo Nossamen
• To: DRMS
• Type & Sequence: SO1
• Media Type: D
• Archive: No

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II.
ADMINISTRATPJE INFORMATION:
1. Permit Number:
2. Operation Name:
3. Current Permftted Ocerator.
Contact Person:
Company Name:
Street:
city:
State:
Area Code:
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~~GI~/~G~}/1~ZipCode:~75
X31 Telephone: 7 9 ~7 ^ J o~ / a
-4. Saoewsor Ocerator. a- ~ ~ ~ Ie1Z S ~d b`a`t ~ 1 ~ $d X ~ ~ ~~' 1
Contact person: Elmo Nossaman
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Company Name:
Street:
Cily:
State: _
Area Code:

iRS Tax ID No. or Social Security No.:
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So aN~i+~ ~ ~ ~ ~~ y 5'T ~ ~ "fie
6100 S. Sooner Road
Okla. City,
___Okla ZipCode:_ 73135 .-
4 0 5 Telephone: [phone]
_ 333. ,~r9d 3
• 5. Aoolication Fee: $1:00 for Hard Rock operations; $ 125.00 for Consh action Materials operations
Make check payab]e to the Division of Minerals and G~logy