REV102364

• Permit No: M1981107
• IBM Index Class Name: Revision
• Doc Date: 1/23/2001
• Doc Name: CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: AM3
• Media Type: D
• Archive: No

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14. C_ormoondence Information
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APPLICANT/OPERATOR (creme, address, and phone of name to bz used on permit)
Contact's Name: David E. Buster Title: Vice President
Company Name: ELB Stone, inc.
So-eet: PO Box 42
Ciry: _ Fairlee
State: Vermont Zip Code: 05045
Telephone Number: 8f 02 1- 222-4540
Fax Number: 8{ 02 1- 222-583 I
PERMITTING CONTACT (if differrnt from applicmUopera[orcrbove)
Contacts Name: Title:
Company Name:
Street:
Ciry:
State:' Zip Code:
Telephone Number: ~1-
Fix Number: ~~ -
INSPECTION CONTACT
Contact's Name: Bemazd Buster Title: Sec. Tres.
Company Name: ELB Stone. Inc.
Street: 2495 C.R. 37 E
City: - Lyons
State: Colorado Zip Code: 80540
Telephone Number: 3( 03 1- 303 823-5659
FaxNtunba: 3( 03 ,, - 823-0173
CC STATE OR FEDERAL LANDOWNER (if anv)
Agency:
Srteet:
Ciry
State:
Telephone Number: 1~ -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
Sute:
Telephone Number.
Zip Code:
Zip Code: