PERMFILE49932

• Permit No: M1978102
• IBM Index Class Name: Permit File
• Doc Date: 3/29/1978
• Doc Name: LIMITED IMPACT AND SPECIAL 10 DAY PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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NOTICE PROCEDURES
After the application has been filed with the Division, notice pro-
cedures outlined in Section 3.2 or 4.2 (whichever is applicable) must be
followed.
ADDITIONAL INFOR*fATION
This space can be referenced for further inforation of any of the items
on this form.
To the best of my knot;ledge, all the information presented in this application
is true and correct.
By' _ 3~r a-,.~Z~ ~~~T/o~,~1,.:~
Title: ~ivir ~rrfF v-//~';,1:C1 L'"~4"4•~
(Signed by individual legally authorized
to bind the operator to this application)