2014-12-12_REVISION - M1980183

• Permit No: M1980183
• IBM Index Class Name: Revision
• Doc Date: 12/12/2014
• Doc Name: New Amendment Submittal.
• From: Brannan Sand & Gravel Co.
• To: DRMS
• Type & Sequence: AM2
• Email Name: TAK
• Email Name: TOD
• Media Type: D
• Archive: No

-3-
1 I. Correspondence Information:
APPLICANVOPERATOR (name,address,and phone of name to be used on permit)
Contact's Name: Fr J r. Title: Q n Q
Company Name:
Street/P.O.Box: -?Sao E _ 8" n nQ" 1/1/gT_ P.O.Box:
City: tr 2
State: Zip Code:
Telephone Number: ( 3 O 3 )- SJ y — r--.�3 (
Fax Number: ( 1-
PERMITTING CONTACT (if different from applicantloperator above)
Contact's Name: Title:
Company Name:
Street/P.O.Box: P.O.Box:
City:
State: Zip Code:
Telephone Number: ( )Fax Number: ( )-
INSPECTION CONTACT
Contact's Name: Title:
Company Name:
Street/P.O.Box: 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: ( )-
CC: STATE OR FEDERAL LANDOWNER(if any)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( )-