REV98918

• Permit No: M1981043
• IBM Index Class Name: Revision
• Doc Name: EXHIBIT H MUNICIPALITIES WITHIN A TWO MILE RADIUS EXHIBIT I PROOF OF FILING WITH CNTY CLERK EXHIBIT
• Type & Sequence: AM1
• Media Type: D
• Archive: No

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14. Correspondence Information:
APPLICANT/OPERATOR (name, e~`ress, and phone of name to be used on permit)
Contact's Name: ~~~!JL~^i ~/ ~/~C/ LL+.r ~;~ Title:1 "- /~~.-^.ei.G~~M <-=~!-~.
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Company Name:
~br_:.o/<,q ~-~
~
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v b'~ y ~
~.
~ .~ ~~i /' : L'~..Or /

Street:
G~ %<- ~. //
Cn%r
~~~ f!N
r _
=/~ _
City: ~~'+c1 l/,~.~' J ~~ ~~//
C_r~ _
State: `. C7 Zip Code: ~i ~d%J' G_i i ~ _
Telephone Number: ~~d ) - <<~~ - `i Z~~-? -
_ /I i
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: Title:
Company Name: _
Street:
City: _
State: Zip Code: _
Telephone Number: S- ) - ~ _
Fax Number: ( ) -
INSPECTION CONTACT
~ ~J ,/'
Individual's Name: ~~jyrC .'C'S ri ~'~ /c' _
Company Name:
Street:
City:
State: Zip Code:
Telephone Number: ~ ) -
Fax Number: ( ) -
CC: --ST'-- _-- FEDERAL LANDOWNER (if anv)
Agency: U~~-°-~Qlr c'7= _/_,d iyn ~!/.A~/A /,c~i~. /.-~ ~:/frr ~/~c=/._~
Street: kc~rit.:,Q-GC` r4'i'Z-E~ ZS~~~4' .=~1~~;.i ~~ ~ _
City: ~~~- CE/~ _
State: C--b Zip Code: ~~~C~ y~ _ _
Telephone p
Number: ~'~O ) - /~}~ ~ ~~~~~ _
CC: STATE OR FEDERAL LANDOWNER (if anv
Agency:
Street:
City:
State:
Telephone Number:
Zip Code: