REV05663

• Permit No: M1995034
• IBM Index Class Name: Revision
• Doc Date: 7/20/2001
• Doc Name: REAPPLICATION TO CONVERT THE BACHUS PIT M-1995-034-01 INTO A 112 PERMIT
• From: BACHUS PIT INC
• To: DMG
• Type & Sequence: CN1
• Media Type: D
• Archive: No

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14. Correspondence Lnform>ation.
APPL{CANT/OPERATOR (¢ame, address, and pho¢e of ¢ame to be used on permit)
Co¢tact'sName: I//~N/LPL /)'/• MISSC'~ Title ~Wn/L~/e
Company Name: BAeNus Pr T. /n.l C.
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.Street. ! O ¢ Z ,$U . I/
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O

State: ~Jf'7 ~OieAD~ Zip Code: S /l0 ~
Telephone Number: ,/
e ~! q ) - S$~ - 3oO'i- EXT /~o
Far Number: 'l I - S 89 - 3 7/ Z

PERMITTING CONTACT (if di$errnt from applica¢Uoperator above)
Co¢tact's Name: ~,A-/~~ Title:

Company Namr.

Street:

City:

State: Zip Code:
Telephone Number. ( _ ) -

Fax Number: ( ) -

INSPECTION CONTACT
Co¢tact's Name: S/4 ~ LC Title:

Company Name:

Street:

City:
State: Zip Code:
Telephone Number. ( ) -
Fax Number: ( ) -
CC STA .OR .D . AI. NOf)WNER ff anv)
Agency: /'On! E -
street:
C itv:
State:
Telephone Number:
Zip Code:
CC: STATE OR FFDF AI rLNDO R (if aqy~
Agency: Nt7 icI F
Street:
GR:
State:
Zip Code:
Telephone Number ( ) -