PERMFILE55162

• Permit No: M1997061
• IBM Index Class Name: Permit File
• Doc Date: 7/17/1997
• Doc Name: CONSTRUCTION MATERIALS LIMITED IMPACT OPERATION 110 RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

-3-
14. Corresuondence Information:
APPLICANT/OPERATOR (name((~, addre1 ss, (and phone of name to be used on permit)
Contact's Name: 1'C r~.nc:_y KP ~4 V ~ S'~ Title: SU pPT U ~ Sn lr
Company Name:
Street:
city: Tv ~eS~uJS
State: C~.C> . Zip Code• RO'7
Telephone Number: ( ~1 ~ d , - q y 9 - ~ ~ ~ ~on
Pax Nvmber: ~ ( ~'7 n 1 - ~ ~ 9 - ~ J~ 5 D
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: Title:
Company Name:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -
Fax Number: f 1 -
INSPECTION CONTACT
Individual's Name:
company Name:
Street:
City:
State: Zip Code:
Telephone Number: ( 1 -
Fax Number: ( 1 -
CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency:
Street:
City:
State: Zip Code:
Telephone Number: I ) -
CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency:
Street:
City:
State: Zip Code•
Telephone Number: ( 1 -