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-3- <br />11. Correspondence Information: <br />APPLICANTiOPERATOR (name, address, and phone of name to be used on permit) <br />Contact's Name: EARL-- NY4w156 -__ Title: ??^-- <br />Company Name: mmAP F6N? . L" <br />Street/P.O. Box: 1q9 I S F PAWKWAy- SuhE ZOO P.O. Box: <br />City: W 1YL z r?1tt <br />State: _ L.o -- Zip Code: Leo ?Z? <br />Telephone Number: <br />Fax Number: ( 5'P3___) - 3(a9-- b o <br />PERMITTING CONTACT (if different from applicantloperator above) <br />Contact's Name: -ror;p Y5E 't'itle: <br />Company Name: 4.7- 4-&N6VL-;n W-r' 4 114G. <br />StreetIP.O. Box: 14yo W /ZX AVe iski fe 1Z4;1 P.O. Box: <br />City: W 5:4TM046,M.r <br />State: 4-0 Zip Code: <br />Telephone Number: ( 3P - 4V7" s>7 35 <br />Fax Number: ( 3613 ) - °IT-A',;' " 039-3 <br />INSPECTION CONTACT <br />Contact's Name: i?OAMM AS AfPt4?oPg&ITe?F?. `Title: <br />Company Name: <br />Street/P.O. Box: <br />City: <br />State: _ <br />Fax Number: ( P.O. Box: <br />Telephone Number: ?? - <br /> <br />Zip Code: <br />CC: STATE OR FEDERAL LANDOWNER if an <br />Agency: ---WA-- <br />Street: <br />City: <br />State: -----.-----•-.--_.-._....... ..._._________._._.__ Zip Code- <br />Telephone Number: -- - -- - ` -- - ------ _ ..------_...- ----------- <br />C(.',- STATE: OR FEERAL LANDOWNER if any) <br />Agency: <br />Street: <br />City: <br />State: <br />Zip Ckxie: <br />Telephone Number: (-_.__.._......_.._._..__.! -