2010-03-30_PERMIT FILE - M2010019

• Permit No: M2010019
• IBM Index Class Name: PERMIT FILE
• Doc Date: 3/30/2010
• Doc Name: New 112c application
• From: Thomas H Smith
• To: DRMS
• Email Name: DMC
• Email Name: SSS
• Media Type: D
• Archive: No

-3-
11. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone off? name to be used on permit)
Contact's Name: Title: OWIVCp
Company Name: `
Street/P.O. Box: /lot EAST 1¢7 ?4 57-. P.O. Box:
City: K/4/u5f5 Ci f%/ ,/ /
State: In 0 Zip Code: In Y- i ¢6
Telephone Number: ( c?? / to ) - 3,3 0 ¢3 5
Fax Number: j &I (a ) - 33 / ZU 44
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: SAIKC.` Title:
Company Name:
Street/P.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number:
Fax Number:
INSPECTION CONTACT
Contact's Name: $A.'YI E Title:
Company Name:
Street/P.O. Box:
City:
State:
P.O. Box:
Zip Code:
Telephone Number: ( ) -
Fax Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: 1V44
Street:
City:
State:
Zip Code:
Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any) ,, /
Agency: / YA
Street:
City:
State:
Zip Code:
Telephone Number: ( ) -