2008-04-23_REVISION - M1993004

• Permit No: M1993004
• IBM Index Class Name: Revision
• Doc Date: 4/23/2008
• Doc Name: SO Application
• Type & Sequence: SO1
• Media Type: D
• Archive: No

H. A D.N I I N I STItVI'I VE I N FO WN I ATI 0 N:
1. Permit Number:
? Opci Nance:
Current Permitted Operator
Contact Person: 9--m P- e
Company Name:
Street:
Cit D a In r
State: C 0 Zip Code: 220 00 — 1368
Area Code. 303 Telephone: 763 - -30 4 16
-1. successor Operator:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
IRS Tax ID No, Or Social Security No.
P. Box - 35
Zip Code: 3 - - 7 0
303 Te leplione:

Application Fee: S100.00 for Hard Rock operations; $125.00 for Construction Materials operations
z
Make check payable to the Division of'Reclamation, Mining and Safcly