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2- <br />I1. ADMINISTRATIVE INFORMATION: <br />1. Permit Number: C36 V <br />'S <br />2. Operation Name: <br />3. Current Permitted Operator: a _ <br />Contact Person:` <br />Company Name: <br />Street: <br />City: <br />State: Zip Code: <br />Area Code: Telephone: ? S <br />4. Successor Operator: <br />C? <br />Contact Person: <br />Company Name: <br />Street: <br />City: State: Zip Code: <br />Area Code: ?-ICl Telephone: y??" JSc?? <br />IRS Tax ID No. or Social Security No.: l <br />- ` -b\% s1? <br />5. Application Fee: $115.00 for Hard Rock operations; $144.00 for Construction Materials operations <br />Make check payable to the Division of Reclamation, Mining and Safety