2009-12-30_PERMIT FILE - M2010002

• Permit No: M2010002
• IBM Index Class Name: PERMIT FILE
• Doc Date: 12/30/2009
• Doc Name: New 110c application
• From: Wagner Rock LLC
• To: DRMS
• Email Name: GRM
• Media Type: D
• Archive: No

-2-
11. Corresoondence Information:
A.PPLICANT/nPERATQR (name, address, and phone of name to be used on permit)
Contact's Name: J,NY )pG34?J Title: f?'S e_r
Company Name: J)JiACWFI?--R O G?_U-0- __v __--- -- -
Street/P.O. Box: q (-eqOV E. HW U qd P.O. Box: "" --`
City: G!'?.1? ----------- rr---
State: Zip Code:
Telephone Number: (9 7® - (o z 9 - %?.? 5 Z
Fax Number:?
PERMITTING CON'T'ACT (if different from applicant operator above)
Contact's Name: sw m e- Title:
Company Name:
Street/P.O. Box: P.O. Box:
City:
State:
Zip Code:
Telephone Number: ( -
Fax Number: ( ) -
INSPECTION CONTACT
Contact's Name: S&AA 9- Title:
Company Name:
Street,'P.O. Box:
P.O. Box:
Citv:
State:
Telephone Number: ( -
Fax Number: ( -
CC: _ STATE OR FEIjE_RAI_ LANDOWNER (if any)
Agency=.'w . ........ ...................
Street:
City:
State:
Telephone Number: (......_.._..__...._.....?? -._..._.._......_
---
CC: STATE OR FED RAL LANDOWNER__ (i.f any)
Agency:
Street:
City:
State:
Zip Code:
Zip Code:
Zap Code:
Telephone Number.: