PERMFILE111988

• Permit No: M1999064
• IBM Index Class Name: Permit File
• Doc Date: 5/26/1999
• Doc Name: CONSTRUCTION MATERIALS LIMITED IMPACT 110 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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~I 4.
Corresooodeuce Information:
APPLICANT/OPERATOR (name, address, and phone of name`to be used on permit)
Contact's Name: __~~ ~ ~ IGSd/r2
Company Name: 77~~ ti 'h
Street: U ~ o Y ~ ~~
City: ~,- c
State: LU o
Telephone Number: (~l~ 1- ~~,5' h~U
Fax Number: (~1-
PERMITTING CONTACT (if different from applicandoperator above)
Individual's Name: S4 rn r _ Title:
Company Name:
Street:
City:
State: Zip Code:
Telephone Number: ~~-
Fax Number: ~~ -
INSPECTION CONTACT
Individual's Name:
Company Name:
Strcet:
Ciry:
State:
Telephone Number
Fax Number:
Zip Code:
CC: STATE OR FEDERAL LANDOWNER (ifanvl/t / l /'~
Agency: (I/ / I1
Street:
CIN:
State: Zip Code:
Telephone Number: L_~-
CC: STATE OR FEDERAL LANDOWNER (if an
Agency:
Street:
City:
State:
Telephone Number
Title: ~ (JP%A~U/
,>4M f Title:
Zip Code: