2004-10-19_REVISION - M1994096

• Permit No: M1994096
• IBM Index Class Name: Revision
• Doc Date: 10/19/2004
• Doc Name: CN-01 Application and Receipt of Correct Appl and Missing Exhibits
• From: High Plains Sand and Gravel LLC
• To: DMG
• Type & Sequence: CN1
• Media Type: D
• Archive: No

REGEIVED
- s - OCT 19 2004
14. Corresuondence Information: Givision of Minerals and Geology
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
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Fax Number: ("1 ~ ) - SI.Q~' ~ r~d
PERMITTING CONTACT (if different from applicanUopereto above)
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Company Name:
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City:
State: Zip Code:
Telephone Number: ( ) -
Fax Number. ( 1-
Contact's Name: ~1ti.~ QS GI.~oUQ. Title:
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Agency: ~ UPIJL
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CC: STATE OR FEDERAL LANDOhF WN,,ERpp(if any]
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Telephone Number
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