PERMFILE60176

• Permit No: M1977407
• IBM Index Class Name: Permit File
• Doc Date: 10/3/1977
• Doc Name: LIMITED IMPACT AND SPECIAL TEN DAY PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

IIOTICE PROCEDliF.ES

After the application has been filed with tiie Division, notice pro-
cedures outlined in Section 3.2 or 4.2 (whichever is applicable; Wust be
followed.
ADDITIONAL I:IPOR2fATI0N
This space can be referenced for further infor-cation of an;~ of t:~e items
on this form.
To the best of my knot:ledge, all the infor:tatioa presented in this applic~ti=
is true and correct.
sy:
Title:
(Signed by individual :Lzgally authorize'
to bind the operator '.o this apolicatio_