PERMFILE106264

• Permit No: M2005077
• IBM Index Class Name: Permit File
• Doc Date: 12/7/2005
• Doc Name: Appl.
• From: Upland Gravel Inc
• To: DMG
• Media Type: D
• Archive: No

-3-
11. ~orresoondeace Ieformatbn:
APPLICANT/OPERATOR (name, address, a~ phone of ttame to be used oo permit)
Contact's Name: ~~(/ ~f/ldP./~G
Compaoy Name:
Street/P.O. Box:
City:
state:
Telephone Number:
Fax Number:
Title: f'/"BS'i d~s~f-
P.O. Box: ~~~0
PERMITTING CONTACT (ddiflerent Eriom applicmtloperatorobove)
Contact's Name:
Compmry Name:
Street/P.O. Box:
Ciry:
State:
Telephone Number:
Fax Number:
INSPECTION CONTACT
Title:
Contact's Name:
Company Name:
Street/P.O. Bor.:
c;ty:
State:
Telephone Number
Fax Number:
P.O. Hox:
CC: STATE OR FEDERAL LANDOWNER (if soul
Agency: 1J~Gl~Yc'~ZGf
Zip Code:
Title: l "~CS/'~/E'/1T
P.O.Box: /380
strew: 28/5" /~' k'yetn'
Ciry: _(i'l~fld A/~i~cf/O~
State: l?O~~/'~c~'d Zip Code: y~~~/.~O~O
Telephone Numbs: f,, ~,° , - 2~1~ -' .~C3..~1~ '- ~/G,!G°G f-OL!/~e~/~
CC: STATE 6R FEDERAL. I.ANDO WNER lif and
Agency:
Street:
City:
State:
Telephone Number: ( 1-
Zip Code:
~a/nrddc zip case: ~/5~1.~
~ 97D I. ~~~ - dsio
~ 970 ) _ ~.~,~- ~5%D
C/~~far~
Ca/orA~1o zp code: 6i52C
t `>70 i - f.~~ - D.SrD
f 97a ~ - ~3~- 65io