Laserfiche WebLink
~- <br />II. ADMIMSTRATIVE INFORMATION: <br />1. Permit Number: <br />h-/98s- ~ z9 <br />2. Operation Name: <br />3. Current Permitted Ocerator: <br /> <br />Contact Person: ~ ~ ti ~ /`r L ~ ~ G O h h L' ~~ <br />Company Name: /Z !~ C ~f1 M q j ~0 ~~ /~ E ~' ova c e J' <br />Street: ~i o x SS `/" ~ <br />City: F1Z a J' ~ °C <br />State: G ~ L ° Zip Code: g ° `~ 5` .z <br />Area Code: --~-~= Telephone: ~2 ~ - S.~ 8 8 <br />4. Successor Ocerator: <br />Contact Petson: ~ FN N/-f L ~ U G of9~ ar <br />Company Name: n U G 0 h /'! y / / ~ °'~ /i~•L•Y-s ~ ,2 c,S T <br />Street: ~ d K fs S` <br />City. .~/tA sE ~ <br />State: C v G o • Zip Code: <br />Area Code: X77 0 Telephone: ~2 ~ ~S`.~ g <br />IRS Tar ID No. or Social Security No.: ~ 2 ~ ~2 b g3~ 9 <br />~. Ao~licadon Fee: $100.00 for Hard Rock operations; $125.00 for Construction Matcrials <br />operations <br />Make check payable to the Division of Minerals and Geology <br />