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- <br />H. <br />1. Permit Number: ! ~ r ! ~ 15 D - ~ D ` <br />2. Operation Name: _ ( l~~i/~ i.J+~~it-7'D.~d// L t`~D~ <br />3. Current Permitted Operator: <br />Contact Person: 0/J,J/ (CCLC7X ~ R7NJKJ,L~~ <br />Compazry Name: ~t~w1 S ~tJL' /e ~.L 1e ~ ~lS.flGZk, <br />Street: ~~ ~' ~ ~- <br />City: ~~LY_<./.t=~c- ~it1YS <br />State: ~,~/fQ0.4 Zip Code: <br />Area Code: ~~~ Telephone: Q~~" ~~~ <br />4. Successor Operator: <br />Contact Person: /~,~2yZ ( V~L1 /.,,1/~j(C` , <br />Company Name: ~~'/1 ~j (~ -bb's ~ <br />Street: `7' / / ~i~G/A~D"4 ~l?/~ <br />City: {~(2E.LC y~/xit <br />State: - -- ---- - ---f-"yFiG€JVL`A~'f3 _7.ip Code: ~ ~(r1~ <br />Area Code: ~~ Telephone: y~,~ - ~~ <br />IRS Tax ID No. or Social Security No.: ~ Z y ~ 3~' Z I ~ N <br />5. Application Fee: $100.00 for Hard Rock operations; $125.00 for Constmction Materials operations <br />Make check payable to the Division of Reclamation, Mining and Safety. <br />