PERMFILE126909

• Permit No: M2005012
• IBM Index Class Name: Permit File
• Doc Date: 3/4/2005
• Doc Name: New 112c Appl
• From: Nick H. Gray
• To: DMG
• Media Type: D
• Archive: No

3-
14. Corresoondencelnformation:
APPLICANT/OPERATOR (name, ad~dre~ss, an/d phone of name to/b~e used on permit) may, " ~
Contact's Name: /ls/~/C /~ `1/~/~U Title: [_i4!//(~~-~
Company Name;

Street/P.O. Box:
City:
State: L
Telephone Number: ~ ~ -
Fax Number ( ) -
PERMITTING CONTACT (if different from
Contact's Namc: 'r1~

Company Name: `~
StreeUP.O. Box: 6 las"

City:

State: L
Telephone Number: r 9'~1 R ) -
Fax Number. ( 1-

INSPECTION CONTACT ~ ~ ,~,p
Contact's Name: / V /C ~ _ - ~~ ~ ~It°~~ Title: t~~I~~I~
Company Name:
S[reet/P.O. Box: ~ ®ICI~x:
City
State:
'1'elephonc Number:
Fax Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if auy~
Agency:
Street:
City:
State:
Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency:
Street
City:
State:
felephone Number
Title: 1.~'L~/~" ~ rt-`t'~
Zip Code:
Zip Code: