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;, <br />-~- <br />II. ADMINISTRATIVE INFORMATION: <br />I. Permit Number: <br />2. Operation Name: <br />M-44• oSZ <br /> <br />3. Current Permitted Ooerator: <br />Contact Person: Sa.++ 1~'~ ~ G l e.~+ c a L. m..,,~ <br />Company Name: /2.~fc Tr)....~ ~...~ ria_ LtL <br />Street: ~. a . ~, x i a ,'t- <br />State: G d Zip Code: Fc b 2'•~ <br />Area Code: 9 7 n Telephone: 4 r3 - ie Z L 0 <br />4. Successor Oberator: <br />Contact Person: G,..e ~ N+~ w: L k <br />Company Name: Z/v +.~..: s ~ PLl ~ 7.e ..: a. ~ < ~C a <br />$tlCet: ~.0. ~rX~~1 (~b ~'1,$7 ~`i sr ~~Y ~ I, <br />State: C O Zip Code: g o ~l A 8 <br />Area Code: A'1 d Telephone: er m 4 - 2 ~i <br />IRS Tar ID No. or Social Security No.: 7 S - 2 q 9'i 9 9 f <br />5. AuolicationFee: $100.00 for Hat•d Rock operations; $125.00 for Construction Materials <br />operations <br />Make check payable to the Division of Minerals and Geology <br />