2003-06-04_REVISION - M1974004 ‎(2)‎

• Permit No: M1974004
• IBM Index Class Name: Revision
• Doc Date: 6/4/2003
• Doc Name: Amendment Application
• From: Lafarge West Inc.
• To: DMG
• Type & Sequence: AM3
• Media Type: D
• Archive: No

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14. Correauondence Information:
APPLICANTfOPERATOR (name, address, and phone of name to be used on permit)
Coniact'sName: ~/D/J-.l! ~DZ
C-
7/(; Title: ~AI-~fl MR~L'A-E+~~
Compaq Name: Ll1 FF} P~ '
1
~ L(JEST~ ~'I~ /~
'~
street/P.O. Box: ~
~CX~ u ~rJP,f'u-(~
.)- (04 P.o. Box:
City: \
J~ENU6~
State: GOI~iL~ Zip Code: gd ~
Telephone Nmnber: .( ~.~ ) - 105 ~- ~{' ~J c3~n
Fax Number: (u~03 ) - ~OS ~- `7Q ~7
PERMITTING CONTACT (if different from applicant/operaior above)
Contact's Name: Title:
Company Name:
StreeUP.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( ) -
Fax Number: ( ) -
INSPECTION CONTACT
Contact's Name: -mil a H-tit ~t7ZCZ1 F Title: ~.A/J.~ l ~/}~(.1 Q E-rC~
CampanyName: ,~F"ARF,F 1.C,F.z,7i ~/IC'
S1reeUP.O. Box: l'~~ L(7 . (o ~ ~ L~tJPyl U P_ P.O. Box:

state: C-F~ t.r~~A() p zip Code: a dZ~-~
Telephone Number: (.~3 ) - b57' ~'+' 3 ~(p
Fax Number: ( 303 ) . b 51 - /~{j ~ -]
CC: STAT£ OR FEDERAL LANDOWNER (if an
Agency:
Street:
Cits:
St:xte: Zip Code:
Telephone Number: ( ) -
CC: STATE OR FEDER°.L LANDOWNER (if anv~
Agency:
Street:
Ciry:
State:
Zip Code:
Telephone Number: