2020-09-15_PERMIT FILE - M2020028

• Permit No: M2020028
• IBM Index Class Name: Permit File
• Doc Date: 9/15/2020
• Doc Name Note: Receipt #33123, M-2020-042
• Doc Name: Application
• From: FMIC
• To: DRMS
• Email Name: TC1
• Email Name: MAC
• Email Name: AWA
• Media Type: D
• Archive: No

-3-
13. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: 6ay4 L . 5keno P E, Title: f
Company Name: FH !C
Street/P.O. Box:
P.O. Box: 75797 -
City: "ak �r"s State:
C CD Zip Code: 90M
Telephone Number:7( 17 ) - �� �`
Fax Number: -
�3
Email Address:
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: -
Email Address Name:
INSPECTION CONTACT (if different from applicant/operator above)
Contact's Name:
Title:
Company Name:
Street/P.O. Box:
P.O. Box:
City: State:
Zip Code:
Telephone Number: { ) -
Fax Number: �_) -
Email Address:
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:
Telephone Number:
State: Zip Code: