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-3- <br />11. Correspondence Information: <br />APPLICANT/OPERATOR (name, address, and phone of name to be used on permit) <br />Contact's Name: Q' 1 Title: O W rN e ✓ ' ?1' e5d en 7� <br />Company Name: �ih �l[>ttS Grad F' �?�ayR� ✓hg <br />Street/P.O. Box: �D O Q/ P.O. Box: 609 <br />City: "sit) $ -- <br />State: W o o M,`h 4 Zip Code: 8 L o g `L <br />Telephone Number: ( 3o 7 ) - Z4/5 - 3 y 2 Co <br />Fax Number: ( 3a i ) _ 2 ys - 39s 7 <br />PERMITTING CONTACT (if different from applicant /operator above) <br />Contact's Name: Do y q Idler Title:'' f r <br />Company Name: ? i B( L) 4 S G r a te c. / - <br />Street/P.O. Box: P.O. Box: 609 <br />City: ��h (3 /v��5 <br />State: W Y o M i V"9 Zip Code: 8 z 0 8 Z <br />Telephone Number: ( 30-1 ) - 2 415' — 3�, 2 (o <br />Fax Number: ( 30-2 )- 2Y5--3 y 5-7 <br />INSPECTION CONTACT <br />Contact's Name: <br />Title: <br />Company Name: <br />�� ln.e <br />('A 5 <br />0' Va , Tn <br />Street/P.O. Box: <br />P.O. Box: �o O 9 <br />City: <br />Rh e <br />State: <br />WV cm <br />t) Q <br />Zip Code: (;�Z o8 z <br />Telephone Number: ( 3o7 ) - Z. q 5 ' 3y 2 (o <br />Fax Number: (30-7 ) - 2 YS - 3 y 57 <br />CC: STATE OR FEDERAL LANDOWNER (if any) <br />Agency: <br />Street: <br />City: <br />State: <br />Telephone Number: <br />CC: STATE OR FEDERAL LANDOWNER (if any) <br />Agency: <br />Street: <br />City: <br />State: <br />Telephone Number: ( ) - <br />Zip Code: <br />Zip Code: <br />