PERMFILE136973

• Permit No: M1993027
• IBM Index Class Name: Permit File
• Doc Date: 3/17/1993
• Doc Name: LIMITED IMPACT OPERATIONS 110 2 RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

i ~
-z-
9. Correspondence Information:
APPLICANTlOPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: Mika ('nlaman and T y S if
Company Name:
Street: 60160 Hioh~aav 69 North
City: Waat.rliff
State: r~,n,-a~,n Zip Code: Ai~s~
Area Code: ~~iTi Telephone: ~R~_~~s~
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name:
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
INSPECTION CONTACT
Individual's Name: _,T~y se; Pert
Company Name:
Street: 60160 Highway 69 North
City: U1a~t r~ i ffa
State: Cnlnradn Zip Code: Ri~s~
Area Code: ~„o;_ Telephone: 7s3-2757 _
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State: Zip Code:
Area Code: Telephone:
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
city:
State:
Area Code: Telephone:
Zfp Code: