2019-12-10_REVISION - M1977020

• Permit No: M1977020
• IBM Index Class Name: REVISION
• Doc Date: 12/10/2019
• Doc Name: Request For Amendment To Permit
• From: Keys Blue Haven LLC
• To: DRMS
• Type & Sequence: AM4
• Email Name: SJM
• Email Name: THM
• Email Name: AWA
• Media Type: D
• Archive: No

-3-
11. Correspondence Information:
APPLICANT/OPERATOR (name,address,and phone of name to be used on permit)
Contact's Name: BE S-James Title: Owner
Company Name: Keys Blue Haven LLC
Street/P.O.Box: P.O.Box: 999
City: Winter Park
State: Florida Zip Code: 32790
Telephone Number: (407 )- 399-5799
Fax Number: ( )_ email [e-mail]
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Michael Ripp Title: Consultant
Company Name: MVR Resources, Inc.
Street/P.O.Box: P.O.Box: 54
City: Delta
State: Colorado Zip Code: 81416
Telephone Number: (970 )- 874-5127
Fax Number: ( )_ email: [e-mail]
INSPECTION CONTACT
Contact's Name: Michael Ripp Title: Consultant
Company Name: MVR Resources, Inc.
Street/P.O.Box: P.O.Box: 54
City: Delta
State: Colorado Zip Code: 81416
Telephone Number: (970 )_ 874-5127
Fax Number: ( )_ email: [e-mail]
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: )-