PERMFILE117481

• Permit No: M2004053
• IBM Index Class Name: Permit File
• Doc Date: 9/13/2004
• Doc Name: Application
• From: Riveras Excavation
• To: DMG
• Media Type: D
• Archive: No

2-
6.
Correanondence Information:
APPLI(:ANT/OPERATOR (name, address, and phone of name to be used on pemut)
Contact's Name: !yl ~ -~o J ~ l U eY'Cc ~ Title: ~ Ut7 /Y ~ 2
Company Name: I II~(2K]S ~r~ AU,4'~'/oy,G
Street/P.O. Box: ~'. U ~ o F 2 ~ P.O. Box:
Ciry:
State:
Telephone Number.
F'ax Number:
/~eW .JVLP Y/~ V Zip Code: 8'75/ ~
`' - ~~~ - 105"9 _ --
f .'~1~5 1- 5'a~ - /059
PERMITTING CONTACT (if66different from applicant/operator above)
Contact's Neme: JCLlYLC 45 O ~Od~
Company Name:
Street/P.O. Box:
City:
State:
Telephone Number: ( ~ -
Fax Number: ~ i -
INSPECTION CONTACT
Contact's Name:
Company Name:
Street/P.O. $ox:
City:
State:
Telephone Number
Fax Number:
P.O. Box:
i7ie (is (lyJOll~ Title:
P.O. Box:
Zip Code:
CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency: ~~ n N F_
street:
city:
State: Zip Code:
Telephone Number: ( 1-
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency: ern ti~
Street:
City:
Slate:
Telephone Number
Zip Code:
Zip Code: