REV90553

• Permit No: M1977071
• IBM Index Class Name: Revision
• Doc Date: 1/21/1999
• Doc Name: HALF MOON PIT PN M-77-071 110 TO 112 CONSTRUCTION MATERIALS RECLAMATION PERMIT CONVERSION APPLICATIO
• From: DMG
• To: LAKE CNTY
• Type & Sequence: CN1
• Media Type: D
• Archive: No

- 3 -
14. Correscondence Snformation:

APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: /~s~i `d~r.•~Lf~~wn•'1f:e4bjTitle:
Company Name: /~s~~ ~Aere.~
Street: /~!7 Be.t 4.6~,/
City: .~PA~/i..`llr
State: !~/~ Zip Code: ~YOh//i/
Telephone Number: ( 'f~f 1 - '~~~~ eF4~
Fax Number: ( 7//f ) - ~~~r'- ~//7
PERMITTING CONTACT (if different from applicant/operator above)
' '~'~
~ br!
~ ~
~
'
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i
l
r~
Contact
s Name: r ~ .
r•
T
e:
e~ .
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~A ~ ~OfJO ~!
Company Name: •
Street: /a!7 d~ ei QG~
City: .lP1t /UiIIc
State: /~0 Zip Code: S('~~e/
Telephone Number: ( '7/4 1 - yi~~-~ 9~JQ
Fax Number: ( 7/ri 1 - 'y~~ 'y~/7
INSPECTION CONTACT
~ /
~
~
Contact's Name: Yf~l4• P!~
e 7~ l'rl' Cl Title:
it/1 ~r ~.S
~~
Company Name: .~e~ ~~uu`Iy
street: ib B sr leC/1
City: .: l~te
State: C'0 Zip Code: 8D'S~G~
Telephone Number: ( '~/`I 1 - '~~lr- '~f ~~
Fax Number: ( ~/~j 1 - '}~~`~ y//'/
CC: STATE OR FEDERAL LANDOWNER (if an v)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: f ) -
CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( 1 -