PERMFILE104963

• Permit No: M1998080
• IBM Index Class Name: Permit File
• Doc Date: 9/11/1998
• Doc Name: CONSTRUCTION MATERIALS LIMITED IMPACT OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

- 3 -
14. CorresDOndence Information:

APPLICANT/OPERATOR (name, addres's',// and phone of name to be used on permit)
Contact's Name: ~//'2F- h H-n ~~PU T/itle:~-O W/VlG',P
Company Name: /"h~ ~ S%Or/G ~'aD~ 4J .3~~~( ~•/~ ~niY //Z t
Street: ~IJ-~~ // G-NT PLn~P S f`~ /~ /~ ~nX ~/2 1
City: ~n a n. (~. fP C .C V
State: ~°n ~n.P~i h/~ Zip Code: ~ /.3 ~ U
Telephone Number: ( q 7!7 ) - ~0 77 - 2 7h 7
Fax Number: ( ~%/) ) - 70 //- ~ `/~./
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Namf
Company Name:
Street:
City:
State:
Telephone Number:
Fax Number:
INSPECTION CONTACT
Individual's Name:
Company Name:
Street:
City:
State:
Telephone Number:
Fax Number:
•~~~N ~rcur'PUE Sf.~f ~~~llk~(~2l~Dtle ~',~~r_,f~
~mm !) V P ~, ~P. P
l'~ ~ rl ~~j 17 7J Zip Code: ~ ( ~~
( ~7D ) - ~~7-~-~67
( Rya ) - ~n~7- ~4~1
CC: STATE OR FEDERAL LANfD~OWNER (if any)
Agency : L,l u r e V9 u ('~ ~ ~.- Iq N c~ /vt 19 n/ A4`e- 1M ~ ~l '(-'
street: ~l~ 1 ~? A rn ~ Nn j.~. ~ ~i i~
city: Ll u r A ~/ca n
~~_
State: ~Ol ~(1 R~11l~ Zip Cod1de: 9/fin ~ II \
Telephone Number: ( 97~ I - ~~7- ~Q7~ CC, n /a r I~.S ~t ~ a qL I
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -