2005-10-18_REVISION - M1992054 ‎(2)‎

• Permit No: M1992054
• IBM Index Class Name: Revision
• Doc Date: 10/18/2005
• Doc Name: Transfer of Permit and S.O. Application
• From: LBCR LLC
• To: DMG
• Type & Sequence: SO2
• Media Type: D
• Archive: No

~_
II. ADMINISTRATIVE INFORMATION:
1. Permit Number: ~
2. Operation Name: ~
3. Current Permitted'Ocerator:
Contact Person: ~
Company Name';
street:
city:
state:
Area Code:
4. Successor Ooerator:,
Contact Person: '
Company Name: '
Street: '
City:
State: '
M -/ 992 -- DSf~

W A L-7~ (3tJM P
FE.SCD ! IyC.
P. 4. 3oX /~QS
f3~oo~r-/~c_r>
-`~ M zip Code: $ 7 S'/3
~O5 Telephone: (o,3z-gZ~9
,svs 3~- X788
~'o DD ~ . ~r 564~`~{
CBC2 ~ t c.C,.
BO ~~,Q~
C~ Zip Code:
Area Code: 3~3 Telephone: ~~ ~D ~D
IRS Tas ID No. or Social Security No.: ~~ ~ - ~ 2 - ~ }'~--
5. Aaalication Fee: ~ $100.00 for Hnrd Rock operations; $125.00 for Construction Materials
',operations
Make check payable to the Division of Minerals and Geology