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DIYIINI5TRATIVEWFORMATION: <br />~_a®oo -1~9 <br />,~/ ~ <br />Current Permitted Operator. <br />Area Code: <br />4. Successor Operator. <br />Contact Person: <br />Company Name: <br />Street: <br />City: <br />State: <br />Area Code: <br />II2S Tax ID No. or Social Security No. <br />~~/ 6 / <br />v zip~cjo~d~ef: /1Z/~f~ <br />Telephone: c~X/ / ~ (~~ / ~~~ <br />/~lf~iV . ~iU <br />Dumb ~ Durnbf~ - /ruc,~1n~ <br />~ / ~~ <br />~/y ~. p <br />~yy,+~ ~ ZipC/o/dpe: lJo7~~/~,~]~ <br />~7 6 t/ Telephone: ~/U " SZ 2 `~ "~~ <br />323-9-~5~~ <br />5. Application Fee: $100.00 for Hard Rock operations; $125.00 for onstruction Materials operations <br />-' -~' <br />Make check payable tb the Ihvision of Mmerals and Geology <br />