PERMFILE112375

• Permit No: M1997035
• IBM Index Class Name: Permit File
• Doc Date: 5/22/1997
• Doc Name: CONSTRUCTION MATERIALS LIMITED IMPACT OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

ld. Correaoondence Information:
APPLICANT/OPERATOR (name, address, an,ryryd phone of name to be used on permit)
Contact' a Name: ~mii/RR o /l ~KE R SR Title: /iE~ o OPfRAr/oaS ~aIIERV/6oR
Company Name: PARK CONNTy RoAO tBR/06fi,
street: /2yG GR-/6 ~ d ~QOX /97
city: FA/ R FLAY
state: (~,roR.4DO zip code: SDyYO
Telephone Number: ( r! / 9 i - $ 3 6 ' .2I7 / ~A7 7 ~'
Fax Number: r 9/ 9 ~ _ g36 - h°R'~~
PERNITTING CONTACT (if different from applicant/operator above)
Individual's Name: Title:
Company Name:
Street:
City:
State:
Telephone Number:
Fax Number:
INSPECTION CONTACT
Individual's Name:
Company Name:
SRME AS
-3-
Zip Code:
GVE
Street:
City:
State:
Telephone Number: ( ) - _
Fax Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency:
Street:
City:
State:
Telephone Number: ( 1 - _
CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency:
Street:
City:
State:
Zip Code:
Zip Code:
Zip Code:
Telephone Number: ( 1 -