2021-07-29_PERMIT FILE - M2021051

• Permit No: M2021051
• IBM Index Class Name: PERMIT FILE
• Doc Date: 7/29/2021
• Doc Name: Application
• From: Miami Road Properties, LLC
• To: DRMS
• Email Name: DMC
• Email Name: THM
• Email Name: AWA
• Media Type: D
• Archive: No

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13. Correspondence Information:
APPLICANT/OPERATOR (name,address,and phone of name to be used on permit)
Contact's Name: ^��o8f M ; Ie s Title:
Company Name: 1"l l rim t
Street/P.O.Box: �j7_`��L'��..� ,V e. f. 10 P.O.Box:
City: oS el- State:_ Zip Code: 7111 A b
Telephone Number: (9-1Cs )- 2IA 9 1 Fax Number: (916 )-2 y9
Email Address: MC.
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: =IE!n r, � c� Title:
Company Name: l
Street/P.O. Box: P.O.Box:
City: e" State: Zip Code:
Telephone Number: ( )- 11 Fax Number: ( )-
Email Address Name: �'n i� » P)k (XI��rS 1,Dt`a,rt P \t. to
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: State: Zip Code:
Telephone Number: ( )-