REV90276

• Permit No: M1978007
• IBM Index Class Name: Revision
• Doc Date: 4/16/1992
• Doc Name: REGULAR OPERATION 112 RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: CN1
• Media Type: D
• Archive: No

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9. Correspondence Information:
APP LICANTlOPERATOR (name, address, and phone of~~l1name to be used on permit)
Individual' S Name: ~A22Er1 ~_ C_,ODPE.2
Company Name: M_pF~A-T ~r.a.JT.~ ~o~ l~~Pra.2i rai~.J t~
Street:
City:
State:
Area Code
~AW Zip Code: QIG2.L
30~ Telephone: 8Z~ - 3 Z I 1
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: _f~1A2.i/i~1 _f~~OQ>~EJ
Company Name: Cf)._)S.,L-TA~~
Street: /~70 '(Z~aw.1~J6..--I ST
~, ty: e2.4.~ ~
State: ~Lo • Zip Code: SI (~ Z~~
Area Code: 303 Telephone: 82.~-OIZ4~`T
INSPECTION CONTACT
Individual's Name: MEaRaI~J 1~1oD2E
Company Name:
Street:
Ctty:
State: Zip Code:
Area Code: Telephone:
CC: STATE OR FEDERAL LANDOWNER (1f an v)
Agency: ~JJ2~.J of ;LA.-_1p I~~ AV ~4 E~~E+J'~
Street: ~ S s F.M EJLSO~..] S'r"
State: l~'~(~ Zip Code: r?IGLS~
Area Code: 303 Telephone: 82~- B24 I
CC: STATE OR FEDERAL LANDOWNER (1f anv)
Agency:
Street:
City:
State: Zip Code:
Area Code: Telephone: