REV10311

• Permit No: M1979163
• IBM Index Class Name: Revision
• Doc Date: 3/2/1989
• Doc Name: SHANNON PIT PN M-79-163 SUCCESSION APPROVAL SO01
• From: MLRD
• To: DIV OF HWYS
• Type & Sequence: SO1
• Media Type: D
• Archive: No

-2-
10. Correspondance Information
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: sc~h g0.C;C-~
Company Name: ~QS ~nslrtas Cv-~-~•~,_
Street: l.as ar`~r+4st Couh~Y Ce4rtlloLLse Roc.r~ a~7
City: `(r;vi.~1~
State: C-~Ic7Y'ar~0 Zip Code: ~/O~Z
Area Code: 7! Telephone: Qyb - 3~k1
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: savne as a6o~2
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
INSPECTION CONTACT (if different from applicant/operator above)
Individual 's Name: s4 h.P as a bou e
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
11. Primary future _ Cropland(CR) _ Pastureland(PL) _ General Agriculture(GA)
land use _ Rangeland(RL) Forestry(FR) _ Wildlife Habitat(WL)
(check one): _ Re sidential(RS) - Recreation(RC) _ IndustrialJCommerciallIC)
Developed Water 1~esources(WR) Solid Waste Disposal(WD)
12. Primary present _ Cropland(CR) _ Pastureland(PL) _ General Agriculture(GA)
land use Rangeland(RL) Forestry(FR) _ Wildlife Habitat(WL)
(check one): - Residential(RS) - Recreation(RC) _ Industrial/Commercial(IC)
Developed Water 1~esources(WR)