PERMFILE118347

• Permit No: M2005075
• IBM Index Class Name: Permit File
• Doc Date: 11/28/2005
• Doc Name: Appl.
• From: Oldcastle SW Group Inc. dba Four Corners Materials
• To: DMG
• Media Type: D
• Archive: No

-3-
11. Correaoondence )<ntormation:
APPLICANT/OPERATOR (nam/e, address, and phone of name to be used on permit)
Contact's Name: f`112r-~ ~ c r'
Compaq Name: l In ~ Co.... 6.r,1'Ls
Street/P.O. Box: ZZ~ ~ ~ ups... ~d P.o. Box:
city: Gra..~ J~,,,~+;e.

State: GO Zip Code: ~~ S(~2
Telephone Number: (aft) ~- 243 - y`~~
Fax Number: (~ ~O ) - Z~ -s9 ~1s

PERMITTING CONTACT ifferent from applicant/operator above)
(if d
Contact's Name: if
>er~
M,'~il-
t Title:

Company Name: /
J
G w, LL4/ ~ ~~ d //~~ p
~ /'I55(. I ~ - - -
S7eeVP.O. Box: // 1 l../ofn.,,lr ,~. ~o~~'
e P.O. Box:
City: /o~
State: ~.(7 Zip Code: ~ I ~g
Telephone Number: { FLU 1- ~`!Z 5 3 z r
Fax Number: ( 3 1- 3 4 j~,, ~ °13 L/
INSPECTION CONTACT
Contact's Name: ~ e`S C7 a~ar' Title:

C
N om
Pazry eme.
StreetlP.O. Box:
City:
State:
Telephone Number. ( 1--
Fax Number: ( ) - -
CC: STATE OR FEDERAL LANDOWNER (if enyl
Agency:
Street:
City:
State:
Telephone Number: ( 1- -
CC' STATE OR FIDERAL LANDOWNER lif anvl
Agency:
Street:
City:
State:
Title: I(ioae~ ~_il
P.O. Box:
Zip Code:
Code:
Zip Code:
Telephone Number: ( ) -