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0 <br />lI. ADMINISTRATIVE INFORMATION: <br />1. Permit Number: <br />2. Operation Name: <br />-2- <br />Make check payable to the Division of Reclamation, Mining and Safety <br />Vy) - - 001 <br />11.) SSQA3 �A 2uh 1 l ou ftQ <br />3. Current Permitted Operator: <br />Contact Person: fl iA-(uL ND t- 0U.&Dv <br />Company Name: f-h LL, - (,_3-0 ∎+J <4 �(4 T \ � <br />Street: V) t L' Q , L + c ■ - <br />City: YVU: `: VC° <br />State: (.c) Zip Code: SC-) <br />Area Code: g Telephone: Sew �7 <br />4. Successor Operator: <br />Contact Person: <br />Company Name: � c C � 2 <br />Street: '�O I ( - Q- 0 +€)CC <br />City: <br />State: ( f) Zip Code: <br />Area Code: hC M Telephone: - se - ) <br />IRS Tax ID No. or Social Security No.: t' t ' D S -446 Telephone: <br />5. Application Fee: $115.00 for Hard Rock operations; $144.00 for Construction Materials operations <br />