PERMFILE125672

• Permit No: M1980233
• IBM Index Class Name: Permit File
• Doc Date: 11/21/1980
• Doc Name: LIMITED IMPACT & SPECIAL 10 DAY PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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NOTICy PROCIDURES
Aftnr tha application has baea filed with the Division, notice pro-
eadures outlined in Section 3.2 or 4.2 (whichever is applicable) must ba
follovad.
ADDITIONAL IiiFOR~L4TI0N
This epaca can ba referenced for further information of any of the items
on this form. ~ _
To the best of my knowledge, all the information presented 1a this applicatioc
is true sad correct.
Title: ~~ ,~
(Signed by individual legally authorized
to bind the operator to thin appliution~.