2010-05-03_REVISION - M1999058

• Permit No: M1999058
• IBM Index Class Name: REVISION
• Doc Date: 5/3/2010
• Doc Name: Revised pages
• From: Greg Lewicki and Associates, PLLC
• To: DRMS
• Type & Sequence: AM1
• Email Name: GRM
• Media Type: D
• Archive: No

-2-
1l. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: r Fri iC '?, Fr G A-& Title:
'???G??? ? o(Z ©? e P RA i i ?
Company Name: C-ltbLcq A?&? 67-iksuE ? J A Qqj FS
Street/P.O. Box: P.O. Box: L'3 8
City:
State: C; F,07t, a'% A Zip Code: 3 c al-
.152-Gil
Telephone Number: ( }O ) - 47
Fax Number: ( - 415 _ 2116
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Title:
Company Name:
Street/P.O. Box:
P.O. Box:
City:
State:
Telephone Number: ( ) -
Fax Number: ( ) -
Zip Code:
INSPECTION CONTACT
Contact's Name: C-- S' G6 A2 Title: T,R,.c. e;Z m6- atf- RAT ioNS
Company Name:
Street/P.O. Box: _
City: _
State: aqz (D26 i Zip Code: 30 01
Telephone Number: ( ??-O ) - _ ?3S _ Q 49 l
Fax Number: ( 4% ) - ?3S - ? 23 6
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State:
Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Zip Code:
P.O. Box: P3%
Street:
City:
State:
Zip Code:
Telephone Number: ( ) -