PERMFILE130492

• Permit No: M1977193
• IBM Index Class Name: Permit File
• Doc Date: 8/30/1977
• Doc Name: LIMITED IMPACT AND SPECIAL PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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NOTICE PROCEDURES
After the application has been filed with the Division, notice pro-
cedures outlined in Section 3.2 or 4.2 (whichever is applicable) nust be
followed.
ADDITIONAL INFORMATION
This space can be referenced for further information of any ~~f the items
on this form.
To the best of my knowledge, all the information presented is this application
is true and correct.
By: rJ ~ ~ \~~a .,1
Title: ,e.i.~'tyir
(Signed by individual le3ally authorized
to bind the operator to this application)