REV94575

• Permit No: M1980003
• IBM Index Class Name: Revision
• Doc Date: 11/14/1996
• Doc Name: TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS APPLICATION FORM
• Type & Sequence: SO2
• Media Type: D
• Archive: No

II

ADMINISTRATIVE INFORMATION:
1. Permit Number:
2. Operation Name:
3. Current Permitted Operator:
Contact Person:
Company Name:
Street:
city:
State:
Area Code:
4. Successor Operator:
-2-

Sohn A. McNulty
7747 County Road 100
Carbondale
co Zip Code: 81623
970 Telephone: [phone]
COgtdCt PerSOn: Gary K. and Sarah Lillian McNulty
Company Name:
Street: 7747 County Road 100
Clty: Carbondale
State: co
Area Code: 970
IRS lax ID No. or Social Security No.:
5. Apprication Fee: 8100.00
Zip Code: 81623
Telephone: [phone]

Make check payable to the Division of Minerals and Geology
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