PERMFILE100569

• Permit No: M2000032
• IBM Index Class Name: Permit File
• Doc Date: 6/9/2000
• Doc Name: CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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1J. Cortesoondeoce Information:

APPLICANTlOPERATOR (Dame, address. and phone of name to be used on permit)
ContacYsName: MARTIN AZGAfrAGA Title: ~llt`IE2
Company Name: M•A• GaN~R-ET6 GOh~51P1A.Cj'Ibhl t ~I~G.
Street: 2323 p,IVER RaAO
City: G~NO JuNG'('IOl~i7-EvtO
State: GolarA r~o Zip Code: SISbrj
Telephone Number: ( 970 ~ - 243- 3~-Z I
Fas Number: ( ~~ ~ - 243- 957
PERMITTING CONTACT (if d~orrnt from applicanUoperator above)
ContacPs Name: S,M ~ ,4$ A'P.Jp ~/ 1= Title:
Company Name:
Street:
C itv:
Stale:
Telephone Number.
Far Number:
INSPECTI~ICONTACT
ContacCs Name:
Company Name:
Street.
Zip Code:
`'JAM6 .4S APJOtI~-- Title:
City:
State:
Telephone Number. ( 1-
Fax Number: ( 1-
Zip Code:
CC~ STATE OR FEDERAT LANDOWNER (if ayl
Agrncy: Nol.t1=
Street:
City:
State:
Telephone Number:
Zip Cade:
CC: STATE OR FEDERAL LANDOWNER (if any
Agency: NON E
Street:
City:
Smte:
Telephone Number:
Zip Code: