2015-01-29_REVISION - M2008070 ‎(3)‎

• Permit No: M2008070
• IBM Index Class Name: REVISION
• Doc Date: 1/29/2015
• Doc Name: Application Form for Transfer of Mineral Permit and Succession of Operators
• From: White River Pit
• To: DRMS
• Type & Sequence: SO1
• Email Name: THM
• Email Name: GRM
• Media Type: D
• Archive: No

STANDARD FORM 299 (05/1009) APPLICATION FOR TRANSPORTATION AND
FORM APPROVED
Pmscxilbed by DOWSDAIDOT UTILITY SYSTEMS AND FACILITIES
OMB Control Number: 0596 -0082
P.L 96487 and Federal ON FEDERAL LANDS
Expiration Date: 1/31/2017
Register Notice 5 -22 -95
FOR AGENCY USE ONLY
NOTE: Before cwgAaft and tiling lm application, tt o applicant should mmpleSdy revkw this padcape end schedule a
ApPG� Number
praappikafion nmft with mprasentatim of the agency responsible for pmceasina the application. Each agency maY have
requkements b be met in pmWng and processing the application. ManY times, wilt the help of the agency
f. ❑
Date Flied
specific and udque
mpraerdalva.'the appikalm can be completed at the proaWicalon meeft.
❑
1. Name and address of applicant (include ZIP code)
2. Name, title, and address of auttwrized agent if
3. Telephone (area code)
Other'
different from item I &dude z1p code)
214-292 -2011
OWL Western Gravel and Disposal, LLC
'cant
8214 Westchester Drive, Suite 850
see item 1
Dallas, Texas 75225
Authortzed agent
4. As applicant are you? (dhemr ate)
a. ❑
Individual
b. ❑x
Corporation•
c. ❑
PartnershiplAssociation'
d. ❑
State GovemrraVState Agency
e„ ❑
Local Government
f. ❑
Federal Agency
ff checked
5. Specify what application is for (check one)
s.
❑
New authorization
b.
❑
Renewing existing authorization No.
a
❑
Amend existing authorization No.
d.
❑x
Assign existing authorization No.
e.
❑
Existing use for which no authorization has been received'
f.
❑
Other'
• ff checked,
detaft under Rem 7
* _- r..dtaa.,nrr... e.vtn mhin aro vrH, a c itizenfs) of the United States? ❑ Yes ❑ No
7. Project description (describe in detalq: (a) Type of system or facility. (e.4., cane, ppmme, roam; fur rcraeeu au�....+w �....�-
specliicalions (Length, width, Wading. eta). (d) term of years needed: ( fime of year of use
areas needed for or operation; (Attach a Volume or sheets, product add' to be
transported; (9) duration and timing of construction: and (h) temporary work
space is needed.)
8. Attach a map covering area and show location of project proposal
9. Stator or Local govgmment approval: ❑ Attached ❑ Applied for ❑ Not Required
10. Nonreturnable application fee: ❑ Attached ❑ Not required
11. Does pm*cl cross international boundary or affect International waterways? ❑ Yes ❑ No (ff yes,' lnd/cde on map)
12. Give statement of your tedwkal and financial capability to construct, operate, maintain, and terminate system for which authorization is being
requested.
The application only pertains to maintaining a haul road, there are no facilities on Federal Lands.
STANDARD FORM 299 (REV. 5/2009)