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REV98994
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REV98994
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Entry Properties
Last modified
8/25/2016 3:22:58 AM
Creation date
11/22/2007 12:23:05 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1973021
IBM Index Class Name
Revision
Doc Date
3/20/2001
Doc Name
TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS APPLICATION FORM
Type & Sequence
SO1
Media Type
D
Archive
No
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<br /> <br />-~- <br />II. ADMINISTRATIVE INFORMATION: <br />1. Permit Number: <br />3~ ~ ~ ~ ~ 3- o~-I <br />2. Operation Name: <br />3. Current Permitted Operator: <br />Mc~rri5~n QL~rT - <br />Contact Person: ~2-('ri C k W e'd . <br />Company Name: CAMAS n(n~nrtc~ , Tn ,. <br />Street: ~l„C15 5 ~C((~~ J(. <br />Citv: (_ n ~IAJLY?.~ <br />State: ~ Zip Cade:'? <br />Area Code: ~ O.~ Telephone: ~ L~ ~ - (O ~d <br />4. Successor Ocerator: <br />ContaaPerson: ~,2~r-irk IA!%iroQ_, <br />Company Name: AnrarP~~, ~~t4f-r-~IPS- WCR, ~( , <br />Street: <br />Citv: ~LL~~ <br />State: Zip Code: <br />Area Code: Telephone: <br />IRS Tax ID No. or Social Security No.: ~4 - <br />5. Application Fee: $100.00 for Hard Rock operations; $125.00 for Construction btaterials <br />operations <br />Make check payable to the Division of Minerals and Geology <br />
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