REV97718

• Permit No: M1994027
• IBM Index Class Name: Revision
• Doc Date: 3/20/2001
• Doc Name: TRANSFER OF PERMIT & SUCCESSION OF OPERATORS APPLICATION FORM
• Type & Sequence: SO2
• Media Type: D
• Archive: No

-~-
II. ADMIMSTRATIVE INFORMATION:
1. Permit Number:
L.I
f~l g4- oa--~
2. Operation Name:
3. Current Permitted Ocerator;
Lovtarror~' DD~a~-ibn -
Contact Person: ~2-~`ri C K W,z ~'D~,
Company Name: CA M A~ Cn I?` r(11J~fJ ,TinC,.
Street: ~ r ,, n5 5 ~. l l ~,r- J~f-.
Cip~: n//~~ ~~ U
State: ~1J Zip Code: ~~'~S
Area Code: ~ D ~ Telephone: Q~L '~ - ~ Odd
4. Successor Ocerator:
Contact Person: ~2~ L_Lk I AI ~L!'C~.,
Company Name: Aol]r-P~"fC., ~r~CLl4~-r^IPS- WCR~ TX1C,
Street:
City: ~Qj"Y't~
State: Zip Code:
Area Code: Telephone:
IRS Tar ID No. or Social Security No.: R4 - Con ' 4 ~"TC
5. AoolicationFee: $100.00 for Hard Rock operations; $125.00 for Construction Materials
operations
Make check payable to the Division of lvtinerals and Geology