PERMFILE132375

• Permit No: M1996076
• IBM Index Class Name: Permit File
• Doc Date: 12/9/1996
• Doc Name: CONSTRUCTION MATERIALS LIMITED IMPACT OPERATION 110 RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

-3-
14. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact•a Name: ~L1dn/~ti `nif7rtfrr~ Yi Title: /J /d y7E=l'
Company Name:
street:
City:
State:
Telephone Number:
Fax Number:
r ~J74 i - ~3~f
Q7o , _ 2~B - S~3z
PERNITTZNG CONTACT (if different from applicant/operator above)
Individual's Name: $2J11~ Title:
Company Name:
Street:
City:
State:
Telephone Number:
Fax Number:
INSPECTION CONTACT
Individuals Name:
Company Name:
Street:
City:
State:
Zip Code:
~ma
Telephone Number: ( 1 -
Fax Number: ( 1 -
Zip Code:
CC: STATE OR FEDERAL LANDOWNER '(if anvl
Agency: ,~O/l e
Street:
City:
State: Zip Code:
Telephone Number: ( 1 -
CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency: /yO~L
street:
City:
State:
Zip Code:
Telephone Number:
LSO/orado Zip Code: 8~J~20