2005-09-12_REVISION - M1980027

• Permit No: M1980027
• IBM Index Class Name: Revision
• Doc Date: 9/12/2005
• Doc Name: Returned Mail
• From: DMG
• To: COE
• Type & Sequence: CN1
• Media Type: D
• Archive: No

-3-
11. Correaoondentt Intormatbn:
APPLICANT(OPERATO R (Dame, address, and phone of name to be used on permit)
Contact's Name: ` 1 r Title:
Compaq Name:

StreeVP.O. Box: ~ P.O. Box:
city: Yh:CI\ L\t~c
s~~: r~~~xaa(~ Zip Code: ~~~~.
Te]ephoneNimmber: (Q~~ ,-"~o1y q~5
FaxN>anber: ~ - ~Iay q ~ p3Z
Lq~p
,
PERMITTAIG CONTAC T (if different from spp
licant/operator above)
Contact's Name: nn
~2~' C ~l l' LLr 1Z-P~1~~ Title: ~'(L S~ ~~-n
Company Name: `T~'Y` 1 - ~l ~ ~r

Street/P.O. Box: ~ ~ t'7 T~ Jr P.O. Box: ~ p C1
city. '(~ t'Y\
state: C~ zip Coae: (1l1'-(.~ 9
Telephone Number: n1
(~ Q 1- ~ <3-~ ^ W ~c~
Fax Number: ~d -~o~~_' Q~~3Z

INSPECTION CONTAC T
Contacts Name: ~f_''~ t ~ ~ ~Y' ~ Y,YYk'..~ Title: PY C°~C ~-e_1'1~
Company Name: Tic i - R\~ e~
StroeVP.O. Box: `12-C~ -~La ~P I~ P.O. Box: l4 q
city: ~Y ~YY~ YYl 1 1 Y~ 0.
state: C~1~('Ael'~ zip Code: $O~Sq
Telephone Numbet: ^~`1 n
(~1 ~ 1- ~
CT ~1 ~'I
Fax Number: ^
( G~ ~ 1- ~d ~ a ~ ~ 7
CC: STATE OR FID A T _ATIDf)WNER ('f anv)

Agency:

Street:

City:

State: Zip Code:
Telephone Number: ( 1- _
CC: STATE OR FIDERAL LANDOWNER (if anvl
Agency:
Street:
Ciry:
State:
Telephone Number
Zip Code: