Laserfiche WebLink
-3- <br />14. Correspondem_ Ltformatlon: <br />APELICANT OPEM TOR (name, address, and phone of name to be used on permit) <br />Contact's Name: <br />t' F N M%f S r- Al L f--IZ <br />Title: <br />Company Name: <br />S G4 t3 La 2 _mag&kc i pic._- - - <br />- - <br />Street/P.O. Box: <br />S i G c xw.,Q4 y 5 rlener <br />P.O. Box: 39S <br />City: <br />'-_>L"A LA <br />State: <br />C. a n. T>& <br />Zip Code: 683S <br />Telephone Number: <br />(-'7 1'9 J. Sy/ ' ,2 3 9 G <br />Fax Number. <br />f 719 2- SSE/ - 42 9C 8 <br />PERMITTII LG QNJACT <br />(if different from applicant /operator above) <br />Contact's Name: <br />%^ft e, a S 6a"_ <br />Title: <br />Company Name: <br />Street/P.O. Box: <br />P.O. Box: <br />City: <br />State: <br />Zip Code: <br />Telephone Number. <br />( , <br />Fax Number: <br />MEECTION CONTACT <br />Contact's Name: SAC. A,g <br />Company Name: <br />Street/P.O. Box: P.O. Box. <br />City: <br />State: <br />Telephone Number: i ) Fax Number. <br />XM La <br />City: <br />State: <br />Telephone Number: f - <br />CC. STATE OR FEDERAL LANDOWNER (if gM) <br />Agency: <br />Street: <br />City: <br />State: <br />Telephone Number: ( ) - <br />Zip Code: <br />Zip Code: <br />Zip Code: <br />