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-~- <br />II. ADMINISTRATIVE INFOIL'~tATiON: <br />1. Permit Number: <br />2. Operation Name: <br />3. Currmt Permitted Ocerator: <br /> Contact Person: <br /> Compazry Name: <br /> Strew: <br /> City: <br /> State: <br /> Area Code: <br />4. Saccessor Ocerator: <br />lvt - -995 - 097 <br />SM.~o-c,.t,e,e rn,NE <br />GARY ~,., ~~ c~~-r yy~ <br />~1fl.1lrki-T ~.- 1'ZFUS~=-1-1 11\,N,N[n~LTP. <br />-5 ~1/~aT MMN S~ • ~t~"E Zb ~ <br />ASpE~v <br />l...OIA~Kl,Jp Zip Code: 8161 <br />1 D Telephone: 9 ZS -S~ Z S <br />Contaec Person: SAy ~a~kT=~ y <br />companyxame: ~E~ SrnuC>U~F~ m,Ne ~m~,a~,/ <br />Street; 61oo~tutrvt.E~ tvrni. Qc. ~x Zo3 <br />City. ~~ ~ <br />State: ~w,e_+~oe Zip Code: 8/6/Z <br />Area Code: 9 7a Telephone: 9Z5 - zo ~f 9 <br />IRS Tae ID No. or Social Security No.: Sy ' / 2 ? S 9 D 3 <br />5. Aoolication Fee: S100.00 for Hard Rock operations; $125.00 for Construction Materials <br />operations <br />Make check payable to the Division of Minerals and Geology <br />