PERMFILE49694

• Permit No: M2004008
• IBM Index Class Name: Permit File
• Doc Date: 3/18/2004
• Doc Name: 2nd Submittal of the Application
• From: Joseph Curtis Harden
• To: DMG
• Media Type: D
• Archive: No

RECEIVED
9. Corresoondeace Iafnrmation:
-z-
APPLICANT/Ol'ERATOA (name address and phone of name to be used on permit}:
MAR 182004
pivision of Minerals end Geology
Contact's Name: T ~ s'f. P fa '~ ~ n7 r r la q/t 17L N Title: oWti R tt / 6Y~KKi37arc
Company Name:
sweet: 640] N.9J7n7T s7.
City: A R V A b A
State: c o c o r¢ rg n o Zip Code: 8 0 0 0 y
Telephone Number: f 3 a J 1 - c/ ~.. ~/ - 6' `t 2 Z
Fax Number. ( A/ ~A 1 - ~y ~i,1
PERNE1TTfNG CONTACT (rf different from app&caat/operator above);
Individual's Name: t h /h ? .q 1 /~ !S o V ? Title:
Company Name:
Street:

Starve: Zip Code:
a
Telephone Nunber: ~ ~ a s 1 - ~~ ~ ° o R M i nr 2 3S
Fax Number. ( ~y„~/t 1 -
INSPECTIOPI CONTACT:
Individual's Name: S,4 i,n ,~ q, s d B o~/? Title:
Campeny Name:
StmK:
City:
State:
Telephone Number:
Fax Number.
Zip Code:
CC: STATE OR FEt1Et2AL LANDOWNER (rt' a~}:
AgeIICy: Fh' p R Yt to C M /.~ J h G C Y ,N / 7Y7 //~/~ T? /. Y R :q YYr~ M/.u C
Sheer s~~ a ~ s A a o v.>: A c^..~. R n c L~ i.a
State: c o c o ~e.q o o Zip Code: Y m `t' S Z
Telephone Number: (3 a? 1 5 6 7^ 'i z s 9
CC: S'L~1TE OR FEDERAL LANDOWNER (rf nay):
Agcncy:
Street
City:
State:
Telephone Number:
F/J J"n/t ,tl J Q~UV/t
Tap Code: