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2- <br />II. ADMINISTRATIVE INFORMATION: <br />1. Permit Number: <br />2. Operation Name: <br />~Y1-Iq4~-r~g1i~ <br />t21.~~61 6~-~.Q ~ it <br />rQh'i~1 ~CtinS fan ~x~ 1~(Y2uP~r !~G <br />3. Cbrrept Permitted Ocerator. <br />Contact Person: '~C3mP.5 V'~ GiDv°I ~,Bi~iri~ 5 YII~I~e.~ <br />/~ --c <br />CompmyName: Rl~~i~iP~~~ i-rr~Ccc10.~ ~1~" <br />sweet: ~r~ ~YJk /I~7 ~ <br />city: ~~~liVj~`7D/~ <br />Stale: ~~ /~ c Zip Code: C~-~~ / <br />Area Code: a ~ Telephone: ~n ~ J ~'~I D, ~? <br />4. Spccessor Operator. <br />Contact Person <br />Compmry Name: <br />Strcet <br />city: <br />state: <br />Area Code: <br />IIZS Tex ID No. or Social Security No.: <br />F1~ral,~r G,. n' SGi~ ai~ I rlY;. ~iv.l. Ll_G <br />~'0 V'7Y>k /rI~FS <br />I..~P,l~iiY~ <br />~~~ zip cone: ~ Syy 9 <br />GAD Telephone; ~IO'~9~~_ <br />5. Aoolicattoe Fee: $100.00 for Hard Rock operations; $125.00 far Conshuction Materiels operations <br />Make check payable >b the Division of Minerals and Geology <br />