Laserfiche WebLink
II. ADMINISTRATIVE INFORMATION: <br />1. Permit Number: <br />2. Operation Name: <br />-2- <br />r►1- t 4s /o -oa <br />3. Current Permitted Operator: 14 ff � <br />Contact Person: 14 Ce.e 01 A � r ca..rl. cl S rr T C.Lzi 4 <br />Company Name: <br />Street: T a U y oL fo G R <br />City: VQ--I't <br />State: p C4.0 - Zip Code: c g 1 I c ' <br />Area Code: -! 7 0 Telephone: c t' 1 S 7 <br />4. Successor Operator: 5+ I f <br />Contact Person: LS'C�.r' l-� B (' _- t al 5+ Cl Gl t <br />Company Name: / - �u1 jliN 23 B rVr (3fad C= S - tec."/e. <br />Street: a 0 t/ / G fed <br />City: s T) �' <br />� / `� /_ <br />P <br />State: �-- Zip Code: O 1-I 1 � <br />Area Code: 9 7O Telephone: c2 q / - Y fir/ S <br />IRS Tax ID No. or Social Security No.: <br />Se 3 X <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 />r &✓L.CI s+ CL cI 7 U G{G Pi T <br />