2024-03-06_PERMIT FILE - M1992051

• Permit No: M1992051
• IBM Index Class Name: Permit File
• Doc Date: 3/6/2024
• Doc Name: Consent Agenda Summary Form
• From: DRMS
• To: Mike Langston Langston Concrete, Inc.
• Email Name: HR1
• Email Name: GRM
• Media Type: D
• Archive: No

Florence Sand&Gravel Pit Consent Agreement
Page 3 of 3
March 6,2024
Operator's Notarized Signature:
As an authorized representative of the Applicant, I hereby attest that the Operator concedes to the above
described violation and agrees to comply with the Corrective Action and Civil Penalty proposed in this
STAFF SUMMARY FORM FOR CONSENT AGENDA ITEMS.
Signed and dated this day of 12024.
(Applicant)
Signature:
Title:
State of
County of
The foregoing instrument was acknowledged before me this day of 12024,
by as of
Notary Public
My Commission Expires:
SIGNATURES MUST BE IN BLUE INK