PERMFILE55812

• Permit No: M1985211
• IBM Index Class Name: Permit File
• Doc Date: 12/18/1985
• Doc Name: LIMITED IMPACT AND SPECIAL TEN DAY PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

• •
NOTICE PROCEDURES
After the application has been filed with the Division, notice pro-
cedures outlined in Section 3.2 of 4.2 (whichever is applicable must be
followed.
ADDITIONAL INFORMATION
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This space can be
on this form.
T pSP R referenced

IP far further information of an}

P C ~ of the items
I
{h f~ 'S O d c/
:~~o 0 or 30 h

To
Ss true Che best of my
and correct. knowledge, all the information presented in this application
sy:
Title: p, _
(Signed by individual ~egally authorised
to bind the operator ,o this application)