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II. ADMINISTRATIVE INFORMATION: <br />1. Permit Number: <br />2. Operation Name: <br />4. Successor Operator: <br />Contact Person: <br />Company Name: <br />Street: <br />City: <br />State: <br />Area Code: <br />IRS Tax 11) No. or. Social. Security No.: <br /># va <br />itah 1 <br />- 2 - <br />20 07s) <br />Lc7%1 2Ies kesD <br />3. Current Permitted Operator: <br />Contact Person: /itzti4 � <br />Company Name: $vv 7Z' 7'k/ 24M7 L2- <br />Street: 33 3 W �1dM ke. 87 / 6 ' <br />6 <br />City: (. / l 9 ! �i�d �� <br />State: ed Zip Code: eolle2 <br />Area Code: _1(23_ Telephone: C3L/ / 2 1 0 <br />Jell)? &ie Tr. <br />l� ab W. /2 ,fie. <br />Dui Per <br />Zip Code: V2-0 <br />J Telephone: __Z ?�_✓ ®D�_ <br />(Do0 5 <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 />T � ,13• ash <br />Oa"-, S <br />yh;s96P.eA-s' <br />