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- <br />R. ADMINISTRATIVE INFORMATION: <br />1. Permit Number: <br />2. Operation Name: <br />3. Current Permitted Ooerator: <br />11'I- 92, asl <br />__ 1-~O rt~ti cr ~ nd/ ~ ~1rz ue L ~'6R~ <br />Contact Person: L./e ~ rn a tl R R v !,lLtr m eL <br />Company Name: ~ /D r P n e t sa n n/ ~ ~~e,L. ~~ <br />street: ~ 9 9 5ih ~- <br />City: Y~ PN rD5 i° <br />State: CD ~ 0 . Zip Code: g / o~ ~ i9 <br />Area Code: ~/ 9 Telephone:'$~t/' 92 5,i <br />4. Successor Operator: <br />Contact Person: ©E~mPR Q RDalarn+eL <br />Company Name: ~IO r'CttCe S!/nc/ (a'ra/tL LLG <br />street: <br />City: <br />State: <br />Area Code: <br />II2S Tax ID No. or Social Security No. <br />'~Q 9 S -~-~, ~d~ . <br />~Pr1rD S P ~y <br />~O ~D • Zip Code: h / a2 ~D <br />7l 9 Telephone: ~ Ff~ - Qs7/ES <br />~ ~ - ~-$' a-~.-G $~ <br />5. Application Fee: $100.00 for Hard Rock operations; $125.00 for Constmction Materials operations <br />Make check payable to the Division of Minerals and Geology <br />