2008-04-23_REVISION - M1978011

• Permit No: M1978011
• IBM Index Class Name: Revision
• Doc Date: 4/23/2008
• Doc Name: SO Application
• Type & Sequence: SO1
• Media Type: D
• Archive: No

ADNIINISTR, INFOWNIATION:
L Permit Number:
2. Operation Name:
Current Permitted 0►)eratot
Contact Person:
Company Name:
Sheet:
City:
State:
Area Code:
4. Successo►• Operator:
Contact Pei
Company Name:
Street:
City:
State:
Area Codc:
IRS Tax ID No. or Social Security No.
v
0 Zip Code: -20 36S
LL6
303_ TelephOTIC: 763 — ,30 4 16
m s Tr
3 5 L4 7
T • Code: --3-7-602-
303 'releplione:
?- 30`1 --
-
AI)I)fication S 100.00 for Hard Rock operations: S 125.00 for ( ollstruction Materials operations
Make check payable to the Division of Reclamation, Mining and Safety