PERMFILE65254

• Permit No: M1978143
• IBM Index Class Name: Permit File
• Doc Date: 4/27/1978
• Doc Name: LIMITED IMPACT AND SPECIAL PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

tloTlce rroccnurrs
After t:~e application leas Veen filed r+itl~ the Dlvi.^,ioti, notice pro-
cedures outll.ned in Section 3.2 or 4.2 (uliicliever is ap~~licahle) must be
follocred.
ADDITIOtI,V, I::POiL'~ATIO:I
This space can be referenced For further information of any of tl~e items
on this form.
•
To the best of my knoisledge, all the inforr`°tion presented in this applicati.cn
is true and correct.
sy: ll~~ ~, ~' ~ ~ vim.
Title: / ~1 S.c>~-/,
(Signed by individual legally aut'rori:.ed
to bind the operator to this application)
•
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