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3 <br /> 12. Correspondence Information <br /> APPLICANT/OPERATOR (Name, Address and Phone of Name to be used on Permit <br /> Individual's Name: <br /> Company Name: <br /> Street: <br /> City: <br /> State/Zip: <br /> Telephone: <br /> PERMITTING CONTACT (If different from Applicant/Operator above) <br /> Individual's Name: <br /> Company Name: <br /> Street: <br /> City: <br /> State/Zip: <br /> Telephone: <br /> INSPECTION CONTACT (If different from Applicant/Operator above) <br /> Individual's Name: <br /> Company Name: <br /> Street: <br /> City: <br /> State/Zip: <br /> Telephone: <br /> PARENT CORPORATION (if any) <br /> Company Name: <br /> Street: <br /> City: <br /> State/Zip: <br /> Telephone: <br /> RESIDENT AGENT (Rule 2.03.4(2)(b)) <br /> Individual's Name: <br /> Company Name: <br /> Street: <br /> City: <br /> State/Zip: <br /> Telephone: �� <br />