2002-03-27_REVISION - M1996076

• Permit No: M1996076
• IBM Index Class Name: Revision
• Doc Date: 3/27/2002
• Doc Name: Completeness
• From: Map Surveys Inc
• To: DMG
• Type & Sequence: CN1
• Media Type: D
• Archive: No

~~~~i~~®
MAR 2 7' 2002
-_-
14.
Oirision of Minerals and lieolagY
street: 33/~ E-3/,,r 2octd
city: C/i~for~
State: !~ Zip Code: ~/S2 0
Telephone Number: (9~/D 1- 7'.~~- 7~~8
Fax Number: ~~ -
PERMITTINGCONTACT (if different from applicant/operator above)
Centact's Name: 5~-(/Yl~ Title:
Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name:
Company Name:
Company Name
Street:
City:
Zip Code:
Telephone Number: ~_~ -
CC: STATE OR FEDERAL LANDOWNER (if any]
Agency: ~f/Oi1 ~
Street:
City:
State: Zip Code:
Telephone Number: ~~ -
State:' Zip Code:
Telephone Number: ~~ -

Fax Number: ~~ -

INSPECTION CONTACT
Contact's Name: 5~/ll ~° Title:
Company Name:

Street:

City:

State: Zip Code:
Telephone Number: (_~ -
Fax Number: ~~ -
CC: STATE OR FEDERAL. LANDOWNER (if any]
Agency: m n
Street:
City:
State: