REV105373

• Permit No: M1979166
• IBM Index Class Name: Revision
• Doc Date: 9/16/1997
• Doc Name: CONSTRUCTION MATERIALS REGULAR OPERATION 112 RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: CN1
• Media Type: D
• Archive: No

1 • •
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14.
Correspondence information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
contact's Name: Earl and Becky Bennett Title:
company Name: Bennett's Reck and Wood
street: 1470 Highway 50
city: Delta
state: ~0 zip Code: 81416
Telephone Number: ,( 970 ) _ 874-4835
Fax Number: ( ti-l O ) - `a -7'~ '" 7 a `~h5
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Marne: Title:
Company Name:
Street:
City:
State:
Telephone Number:
Fax Number:
INSPECTION CONTACT
Contact's Name:
Company Name:
Street:
City:
state:
Zip Code:
See applicant/operator Title
Telephone Number: i ) - _
Fax Number: ( ) - _
CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency: none
Street:
City:
State:
Telephone Number: ,( ) - _
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency: none
Street:
City:
State:
Telephone Number:
Zip Code:
Zip Code:
Zip code: