REV89916

• Permit No: M1999034
• IBM Index Class Name: Revision
• Doc Date: 3/20/2001
• Doc Name: TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS APPLICATION FORM
• Type & Sequence: SO1
• Media Type: D
• Archive: No

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II. ADMIMSTRATIVE INFORMATION:
1. Permit Number:
•
M ~g ~ a3Q
2. Operation Name:
3. Current Permitted Operator:
W t~O~.LIF~ A~.O~
Contact Person: ~a-I-ri ~. K U/a.rd .
Company Name: CAMAS Cnlo~a,~ , nL.
Street: ~ (~ ~ 5 5 . ~ f l ef- v~".
Cih~: ~ kr°Ititk2%~
State: ~ Zip Code: ~~~SS
Area Code: ~,0~ Telephone: ~~C'~- ~D 1d
4. Successor Ocerator:
Contact Person: ~/L~-r I L~ 1fl/!1I'GL
Company Name: Alyar-P~-~C. ~~ItS~-r~IPS - WCR~ TXIL,
Street:
City: ~GLI'Yl~'
State: Zip Code:
Area Code: Telephone:
IRS Tax ID No. or Social Security No.: 434 - C4~ - 4' i4~
5. Application Fee: $100.00 for Hard Rock operations; $125.00 for Construction Materials
operations
Make check payable to the Division of Minerals and Geology