2011-05-16_REVISION - M1988052

• Permit No: M1988052
• IBM Index Class Name: REVISION
• Doc Date: 5/16/2011
• Doc Name: SO Application
• From: Rick L Hunt
• To: DRMS
• Type & Sequence: SO1
• Email Name: JLE
• Media Type: D
• Archive: No

-2-
II. ADMINISTRATIVE INFORMATION: _ /q ?I y CS?
1. Permit Number:
2. Operation Name:

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.:
/ C -k
/ 66
CU I orc-d 0 Zip Code: 16 7
3 b3 Telephone: l?0 l0
CG ?bYa ?U Zip Code: b U ?U 7
3D3 Telephone: `v ' `r '
:
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