2003-06-26_REVISION - M1988057

• Permit No: M1988057
• IBM Index Class Name: Revision
• Doc Date: 6/26/2003
• Doc Name: Submittal
• From: Canyon Sand & Gravel
• To: DMG
• Type & Sequence: AM1
• Media Type: D
• Archive: No

- 3 -
14. Correspondence Information:
APPL]CANT/OPERATOR (name, address, a1nd phone of name 1toLbe used on permit)
Contact's Name: ~6ef=l- S. C~c~Ti ' Title: n(.Jn~%)~ /22.~_
Company Name: ~ J~
Street: U • ^ r~ ,~ r c 2 ~ (o~ ~~.
City:
State: ~~ Zip ode: ~ ~~~
Telephone Number: ~~- ~~~ -~`7O'x
Fax Number: ~- 7~~ - Y7~~
PERMITTING CONTACT (if different from applicanUoperator above)
Individual's Name: Title:
Company Name:
Street:
City:
State: Zip Code:
Telephone Number: ~~-
Fax Number: ( 1-
INSPECTION CONTACT
Individual's Name: ~ 1 c Me. Title:
Company Name:
Street:
City:
State: Zip Code:
Telephone Number
Fax Number:
C: STATE OR FEDERAL I ANDOWNER (if an
Agency:
Street:
City:
State:
Telephone Number
Zip Code:
CC: STATE OR FEDERAL LANDOWNER (if an
Agency:
Sheet:
Ciry:
State:
Zip Code:
Telephone Number: ~~-