2008-01-10_REVISION - M1990057 ‎(9)‎

• Permit No: M1990057
• IBM Index Class Name: REVISION
• Doc Date: 1/10/2008
• Doc Name: Inadequate SO application
• From: DRMS
• To: Capital Gold Corporation
• Type & Sequence: SO1
• Email Name: ECS
• Media Type: D
• Archive: No

-2-
II. ADMINISTRATIVE INFORMATION:
1. Permit Number:
2. Operation Name:
3. Current Permitted Operator:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
4. Successor Operator:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
IRS Tax ID No. or Social Security No
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P, ?. Box 55Z
Lea 11'1 (tie
C 0 (d r a O n zip code: ?4-(c I
-7 0 Telephone: Z 1 6
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Zip Code:
7 Q Telephone:
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5. Apolieation Fee: $100.00 for Hard Rock operations; $125.00 for Construction Materials operations
Make check payable to the Division of Reclamation, Mining and Safety