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-2- <br />II. ADMINISTRATIVE INFORMATION <br />1. Permit Number: <br />2. Operation Name: <br />3. Current Permitted Operator: <br />4 - - - 7? - - 2- -,-? -- 2- <br />C Ga q <br />Contact Person: ` �/ © ev" j?� <br />Company Name: A'L C-40 ( NC.. DD <br />Street: 2-0 0 - 7 <br />City: T—© C- rDl� -� <br />State: 0 0 Zip Code: 9 1010 - 1 <br />Area Code: Telephone: 2 G L 4 ' 1 <br />4. Successor Operator: <br />Contact Person: <br />Company Name: <br />Q t <br />Street: I k Gj <br />City: 0-4A <br />State: Zip Code: �/� 'A /±D <br />Area Code: Telephone: , 7� / 2 ' 4 � <br />IRS Tax ID No. or Social Security No.: <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 <br />