PERMFILE121132

• Permit No: M1977326
• IBM Index Class Name: Permit File
• Doc Date: 9/30/1977
• Doc Name: LIMITED IMPACT & SPECIAL 10-DAY PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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"iOTICE PROCEDURES
•
After the application has been filed with the Division, notice pro-
cedures outlined in Section 3.2 or 4.2 (whichever is applicable) must be
followed.
ADDITIONAL I2iFORPfATIO;i
This space can be referenced for further information of any of the items
on this form.
To the best of my knowledge, all the infomation presented ie this application
is true and correct.
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_~ 10428 .?_
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~~~~ninn\\\``
(Signed by individual legally authorized
to bind the operator to t;iis application)
Prepared by:
R. ephen Schermerhorn, P.E.
President
Impact Environmental Consultants
•