2009-03-19_REVISION - M1987131

• Permit No: M1987131
• IBM Index Class Name: REVISION
• Doc Date: 3/19/2009
• Doc Name: SO Appl
• From: Fremont Paving & Redi-Mix, Inc.
• To: DRMS
• Type & Sequence: SO3
• Media Type: D
• Archive: No

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II.
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ADMINISTRATIVE INFORMATION:
1. Permit Number:
2. Operation Name:
MNY7-N
LA EAUE wES?, r?JC.
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.
aJ FtLrSCH-1-go
LA P?aa-G is W ES T 1NC
1 o 1-70 e t-?.? tZe ?t R40C ti wAY
W F-S7VI'1 rNr57ER
Zip Code: g w a
303 Telephone: _6 67 - 4000

2..t.Vn.oO7 1'AU1N,9 4- SEAI-mix. f n1?
93q w4c- kcN2rr- 4oE
(2-0 Zip Code:
`?'
1' Inl Telephone: 91 5 - .3,2(e' /
9`i -L 'o i
5. Application Fee: $115.00 for Hard Rock operations; $144.00 for Construction Materials operations
Make check payable to the Division of Reclamation, Mining and Safety