2006-09-14_REVISION - M2002094 ‎(2)‎

• Permit No: M2002094
• IBM Index Class Name: Revision
• Doc Date: 9/14/2006
• Doc Name: Transfer of permit & succession of operators application form
• From: Sky Ute SAnd & Gravel, LLC
• To: DRMS
• Type & Sequence: SO1
• Media Type: D
• Archive: No

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II. ADMINISTRATIVE INFORMATION:
1. Permi[ Number.
2OOZ - G`/y
2. Operation Name:
3. Current Permitted Operator:
Contact Person:
Company Nate:
Street;
CIIy:
State:
Area Code:
4. Successor Operator:
Contact Person:
Company Name:
street:
City:
State:
Area Code:
IRS Tax ID No. or Social Security No.:
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[o lo~a c~0 Zip Code: R I So/
Y7O Telephone: zy5 - ~//o/
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S,~ G!-/e SaN~ ~(r~nve~ LLC
P o aox 350
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[o loi ado Zip Code: 8/(37
`r7~ Telephone: 38Z-0609
56- ~~/38475
5. Analication Fee: $100.00 for Hard Rock operations; $125.00 for Construction Materials operations
Make check payable to the Division of Reclamation, Mining and Safety