2019-12-04_PERMIT FILE - M2019045

• Permit No: M2019045
• IBM Index Class Name: Permit File
• Doc Date: 12/4/2019
• Doc Name: Application
• From: James Thomas
• To: DRMS
• Email Name: TC1
• Email Name: MAC
• Media Type: D
• Archive: No

-2-
9. Correspondence Information:
APPLICANT/OPERATOR(name,address,and hone of name to be used on permit):
Contact's Name: ,�vtin r� 1 tin Pr Title:
Company Name:
Street: G - ► P.O.Box:
City:
State: 0 Zip Code:
Telephone Number: ( "(1 ' ) - N4 -
Fax Number: ( L -
PERMITTING CONTACT(if different from applicant/operator above):
Contact's Name: Title:
Company Name:
Street: P.O.Box:
City:
State: Zip Code:
Telephone Number: ( L Fax Number: ( -
INSPECTION CONTACT:
Contact's Name: Title:
Company Name:
Street: P.O.Box:
City:
State: Zip Code:
Telephone Number: ( L Fax Number: ( Z -
CC: STATE OR FEDERAL LANDOWNER(if any): !� _
Agency: A - ►7 'V �2�,�i kES
Street:
City: ' r 7 1
State: `! /2/1 n 0 Zip Code:
Telephone Number: ! ' -
CC: STATE OR FEDERAL LAN OWNER(if any):
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -