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II. ADMINISTRATIVE INFORMATION: <br />1. Permit Number: <br />2. Operation Name: <br />-2- <br />3. Current Permitted Operator: <br />Contact Person: Yr 2t <br />Company Name: } ]AL LL ..L1?¢.vi <br />Street: n 1 ( -CA3 At ' <br />City: <br />State: Zip Code: 1 <br />Area Code: Q37O Telephone: SP 2 <br />4. Successor Operator: <br />Contact Person: ti' _ <br />Company Name: L„,y C <br />l <br />Street: 3 C)) 1�— <br />City: 1'ti1 <br />State: Zip Code: 6051 <br />Area Code: / 7b E <br />Telephone: S) 7d-7 ) <br />IRS Tax ID No. or Social Security No.: 84 - C) E f S 8446 <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 />-arm - 14 <br />A)o -# / A R xtci v`32._ p-k <br />