PERMFILE104975

• Permit No: M1989044
• IBM Index Class Name: Permit File
• Doc Date: 4/7/1989
• Doc Name: LMITED IMPACT OPERATION 110[2] APPLICATION FORM
• Media Type: D
• Archive: No

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10. Correspondance Information
APPLICR~NT/OPERATOR (name, address, and phone of name to be used on permit)
Individual 's Name: H ARoi !1 ~ ~ qR ' IL
Company Name: ~'N~ !'L~RC OR'PnRAnOAI
Street: l BOG 1 TELLER C'.o~-JrY 1
c; ty: FLORTSSHIvT
State: ~ o~nRADf~ Zip Code: 57OS?16
Area Code: ~~q Telephone: (,87-3~~6
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name:
Campar~y Name:
Street: ,S,qM~.
City:
State: Zip Code:
Area Code: Telephone:
INSPECTION CONTACT (if different from applicant/operator above)
Individual's Name:
Company Name:
Street: S Ann ti
City:
State: Zip Code:
Area Code: __ Telephone:
11. Primary future _ Cropland(CR) _ Pastureland.(PL) _ General Agriculture(GA)
land use Rangeland(RL) Forestry(FR) _ Wildlife Habitat(WL)
(check one): = Residential(RS) 1? Recreation(RC) Industrial/Camnercial(IC)
Developed Water esources(WR) _ Solid Waste Disposal(WD)
12. Primary present _ Cropland(CR) ~'Pastureland(PL) _ General Agriculture(GA)
land use Rangeland(RL) _ Forestry(FR) _ Wildlife Habitat(WL)
(check one): - Residential(RS) Recreation(RC) _ Industrial/Commercial(IC)
_ Developed Water l~sources(WR)