PERMFILE72617

• Permit No: M2004045
• IBM Index Class Name: Permit File
• Doc Date: 2/7/2005
• Doc Name: 110c New Appl
• From: Thomas H. Smith
• To: DMG
• Media Type: D
• Archive: No

-3-
14. Cornsnondence Information:
ICANT/OPERATOR (mme, adds. a~ phone ofmme to be used on Pemrit)
CoNac@sName: TNoMAS II, S/rl/7//~ TiNe: OWIUE~~O~E',Zgja,~
Company Name: n//A
Street/P.O. Box ~7 0 ! C: / ~ 7 7A 57"IPEET- P.O. Box:
city: lCAivSAS C l ~ ~
State: /}'1 o zip Code: ln¢ /4G
Telephone Number: j 8 l ~0 1- _/~.3 / - O 4~3.j
Fax Number: ( 8 /!o ~ - 3 3/ - Zo 4= I
Contacts Nano:
Company Name:
Street/P.O. Box
City:
State:
Telephone N~1bei:
Fax Number:
ECPSON CONTAC
Contact's Name:
Company Name:
Street/P.O. Box:
City:
state:
Telephone Nonibra:
Fax Number.
~ C~4/I?CX'A
~ Zip Code: ,Q //O ~
( '719 ~- .585- X55 9
~l _ sag- 3 s~z
L /// • ~u 5 SE= LC- Trtte; LAND SN,eUc~~~~i?~T
qD 4Z SD. /D (o ~C~• P.O.Box
~ L/1 /ho5.4
['17 Zip Code: ~ //O ~
~ 7/9 ~- 589- 455 9
( 7/9 )- SFh9- 3572
CC: STATE OR FEDERAL LANDOWNHR fif aml
Agency: ~.~
Street:
City:
State:
Telephone Number. ( 1-
Zip Code:
tx'• STATE OR FEDERAL LANDOWNER (if anvl
Agmcy:
Street
City:
State:
Zip Code:
Telephone Number: ( j -
9D¢Z .SO • /D(a ~d. P.O. Box