PERMFILE63313

• Permit No: M1995038
• IBM Index Class Name: Permit File
• Doc Date: 5/16/1995
• Doc Name: LIMITED IMPACT OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

-Z-
9. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: _~~..':.__~t2iQ./7f~lc _
Company Name: ~/y)7Fr'~~ CDn~S~-runt>L~~~[ Sq/n .
Street: ~~~ 1,5 Q X ~ /~/
City: ~~~dY,4 /~
State: C-0/b Zip Code: ~/~h3 /
Area Code: .~ ~ ~ Telephone: ~ ~/ ~ Lj-~~74 - ~ F 3~7- 1j-3iG
PERMITTING CONTACT (if different from applicant/operato/r above)
Individual's Name: `~~~'~~ /?~ ~~ L i'~~~/.cr <~.~~-~ , r/ i.-
Company Name:
Street:
City:
State:
Area Code:
INSPECTION CONTACT
Individual's Name:
Company Name:
Street:
c; ty:
State:
Area Code:
Zip Code: ~~/z/~~-
Telephone: ~~i>S" ~3~
~'D~ ~nx ~l~ _
ham- Pr,~ /n.~ P
n nlnra~ln Zip Code: ~'/~3/
_~n ~ Telephone: _~~ZL~~7~ o1e ~'}~-~-31 ~~
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency:
Street:
City:
State:
Area Code: Telephone:
CC: STATE OR FEDERAL LANDOWNER Cif anv>
Agency:
Street:
C1ty:
State:
Area Code: Telephone:
Zip Code:
Zip Code: