REV100229

• Permit No: M1978342
• IBM Index Class Name: Revision
• Doc Date: 5/19/1997
• Doc Name: TRANSFER OF PERMIT & SUCCESSION OF OPERATORS APPLICATION FORM
• Type & Sequence: SO4
• Media Type: D
• Archive: No

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ADMINISTRATIVE INFORMATION:
1. Permit Number:
2. Operation Name:
3. Current Permitted Operator:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
4. SUGCeSSOr Operator:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
IRS Tax ID No.
5. Application Fee

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Perry A. Flanigan
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r~r~~////dl/~///U~l Ryan Ltd
1.Y0 9 ~. 2~N _
lYl6 ir-r,e'as ~~
Llb. Zip Code: / 4 /
9~a-- Telephone: ,~5~1~ ~'~~S
/yl,~ D,d?/c~ Zip Code: C1 D-~~ _
770 Tetephone:ej~7 ~~~o
or Social Security No.:
5100.00
Make check payable to the Dlvtston of Minerals and Geology