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- <br />Q ADMQVISTRATIVB IlYFORMATION: <br />1. Permit Number: M-1994-114 <br />2 OperafiooNeme. Kagan & Son South Pit <br />3 <br />CantxlPctaon: Arthur_ L. Nordyke <br />CampaoyName: ~[ordvke Construction, Inc. <br />Street: ~775$_Hwv 69 South. P.O. Box 29 <br />City: waate7; ffe, <br />State: n..7 nr~An Zip Code: R1~52 <br />~~= 719 Telephme: 7H3-2747 <br />4, Sacceaaoe Otxntor. <br />Cmtactpe+soo: Andrew Kagan and Rebecca N~. Kagan <br />Cottrpnoy Name <br />Sucre _ 555 Ernest Ave. <br />City. Westcliffe <br />State: rnlnrat3n Zip Code; $1252 <br />Arra Code: 7'I 9 Telephone: 7 F,i 3- 2 8 6 7 <br />IRS Tax ID No. or Social Seciuiry No.: <br />5. AooMritbn Fet~ SI00.00 for hard Rock S 125.00 of Coostructiw Materials operetiws <br />Make check payable to the Divisor of Minerals and Geology <br />