2014-08-01_PERMIT FILE - M2014041 ‎(2)‎

• Permit No: M2014041
• IBM Index Class Name: Permit File
• Doc Date: 8/1/2014
• Doc Name: New 110‎(1)‎ Application
• From: Russell Painter
• To: DRMS
• Email Name: TAK
• Email Name: TC1
• Media Type: D
• Archive: No

-2-
9. Correspondence Information:
APPLICANT/OPERATO (name,address,and pjlkne of name to be used on permit):
Contact's Name: ' '� Title:
Company Name:
Street: I � L��.� 2 P.O. Box:
� �
City: 6 jr ►i
State: C o 1 b t-0� b �r Zip Code:
O
Telephone Number: r i 9_� - 5
Fax Number: ( 1 -
PERMITTING CONTACT (if different from applicant/operator above):
JL
Contact's Name: S & M Z X g Title:
Company Name:
Street: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( L Fax Number: ( ) -
INSPECTION CONTACT:
Contact's Name: Le 2 C, Title:
Company Name:
Street: P.O. Box:
City:
State: Zip Code:
Telephone Number:Fax Number:
CC: STATE OR FEDERAL LANDOWNER(if any):
Agency:
Street:
City:
State: Zip Code:
Telephone Number: L -
CC: STATE OR FEDERAL LANDOWNER(if any):
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ) -