2005-04-08_REVISION - M1982141

• Permit No: M1982141
• IBM Index Class Name: Revision
• Doc Date: 4/8/2005
• Doc Name: 112c Amend
• From: Moffat Limestone Company
• To: DMG
• Type & Sequence: AM1
• Media Type: D
• Archive: No

-3-
14. Corresoondenee Information
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name; ~e .t/ ~5 7'EEL~ Title: ~ L~ E~ ~E~S/AE~T
Company Name: MOC~'_19'j nn
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~, /MFSTD/
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E YC.
StreedP.O. BOX: [fn© ~TG~'`i ~
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/~
~ c5, ~!a-'Y 'J"~~ P.G. BOX: ~3 7

Crty: ~

Stete: Zip Code: ~~
Telephone Number: (9 ~j4 ) - ~1
ry
~o~
" c3~° ~~

Fax Number:
(~ 7D ) - q.
.t
q
cX %oC - c~ `dS

PERMITTING CONTACT (if different from applicant/op
erator above)
Contact's Name: oS~9 /rI ~ ^^
f~S .+T~i~O //E Title:

Company Name:

Streei/P.O. Box: P.G. Box:

City:

State: Zip Code:

Telephone Number: ( ) -

Fax Number. ( ) -

INSPECTION CONTACT
Contact's Name: ~fI//7E ~S' ~(30 !~~ Title:

Company Name:

Street/P.O. Box: _ _ _ _ _ P.O. Box:
State: ~..~ ~ D.P~OD Zip Cade:
Telephone Number. 7D - n oS ~ ' 4'~'¢
CC• STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State; Zip Code:
Telephone Number: ( 1-
City:
State: Zip Code:
Telephone Number: ~ ) -
Fax Number: ( ~ -