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2007-11-19_REVISION - M1985023 (3)
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2007-11-19_REVISION - M1985023 (3)
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Last modified
6/16/2021 2:19:07 PM
Creation date
3/7/2008 8:30:38 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1985023
IBM Index Class Name
REVISION
Doc Date
11/19/2007
Doc Name
SO Application form
From
Duane E Hollenbeck
To
DRMS
Type & Sequence
SO2
Media Type
D
Archive
No
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II. <br />RE~~~~~~ <br />OCT 2 g 1007 <br />-2- Division of Reclamation, <br />ADMINISTRATIVE INFORMATION: Minm9 and Safety <br />l . Permit Number: ~ ~ I ~ ~~ l ~ Z~ <br />2. Operation Name: ~~1~~ ~~~~ ~~ <br />3. Current Permitted Operator: <br />Contact Person: ~(~ ~l /~s'~L!/ ~ yl`-- <br />Company Name: ~~ lI ~~ ~ ~ C ~~ ~~C <br />Street: -" ~ (~ ~~ X <br />City: ~1 u ~ ~ iS 6 ~ <br />State: ~~ Zip Code: ~ ( 2~ V <br />Area Code: ~ Telephone: ~~ '~ Q~S <br />4. Successor Operator: <br />Contact Person: ~ A 0Io-e Ci • ~% oIIPn~C l~- <br />Company Name: <br />Street: ~ ~ • ~ O ~ X02 <br />City: U n ~i, CS /~ / <br />State: ~ V Zip Code: ~ / Z~ ~' <br />Area Code: ~ ~ v Telephone: 1 ~ ~ / ~ ~ ~~~ <br />IRS Tax ID No. or Social Security No.: ~~ ~ ~` `G G~ <br />\~'~ 1 ~l ~ <br />5. Aaplication Fee: 1~/ for Hard Rock operatio ; $1 0 for onstruction Materials operations <br />Make check payable to the Division of Reclamation, Minin <br />
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