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~ <br />U <br />-~- <br />II. ADMINISTRATIVE INFORMATION: <br />1. Permit Number: <br />n <br />u <br />M~5- llZ <br />2. Operation Name: <br />3. Current Permitted Operator: <br />I~l o•F~ i n~ . - <br />Contact Person: ~~~-~ri C k WA~d . <br />Company Name: CQ r'1 AS Cn~o~arln , i~(_. <br />cit.: L~ k>;wrx~~ <br />State: ~ Zip Code: ~~~5 <br />Area Cade: ~D~ Telephone: Q~'~- ~O^1d <br />4. Successor Operator: <br />Contact Person: ~l'/L{~ LTA IQ1 !11'C~. <br />Company Name: ~G-P~ T~~(,{4fi^IPS - WCR, ~L, <br />Sveet: <br />City: `~LLYYIG <br />State: Zip Code: <br />Area Code: Telephone: <br />IRS Tas ID No. or Social Security No.: R4 - C~ ~ 4 ~~~ <br />5. Apulicatian Fee: $100.00 for Hard Rock operations; $125.00 for Con6truction Materials <br />operations <br />Make check payable to the Dig ision of Minerals and Geology <br />