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, <br />I <br />4 <br /> <br />-2- <br />Successor Operator: <br />Contact Person: <br />Company Name: <br />Street: <br />City: <br />State: <br />Area Code: <br />IRS Tax ID No <br />5 <br />III. 1 <br />Application Fee: <br />5100.00 <br />Telephone : 3 5z-«157 <br /> <br />Make check payable 1:o the Div151on of Minerals and Geology. <br />Yes: x As the successor operator do you have a complete copy, as is <br />available, of the approved reclamation application to <br />No: Include any permit modifications? <br />A copy of the approved application and any modifications to the <br />permit may .be purchased through the Division. Unless you specify <br />xhich portions of the permit file you xant copied the entire file <br />will be copied. The Division will send the entire file, or <br />portions you specify, to an outside vendor and you will be billed <br />accordingly. <br />2. Yes: x Have you verified that tiie permit area you are assuming <br />reclamation responsibility for is the area described in the <br />No: approved permit application? <br />3. Yes: x Ilave you verified that you have legal right-of-entry to conduct <br />mining and reclamation? We recommend that the lease granting <br />No: legal right-of-entry also include a provision that grants you the <br />right to complete reclamation in the event the legal <br />right-of-entry is terminated. <br /> <br />sea[[ rl,s; <br />1411-I[win Gms[nictiou Co. <br />ICS nc G59 <br />Crw 1oY <br />~ Zip Code: nrlr,~z <br />303 <br />or Social Security No.: <br />