2010-05-04_REVISION - M1999058

• Permit No: M1999058
• IBM Index Class Name: REVISION
• Doc Date: 5/4/2010
• Doc Name: Notices
• From: DRMS
• To: Various
• Type & Sequence: AM1
• Email Name: GRM
• Media Type: D
• Archive: No

03-MAY-2010 04:06PM FROM-DIV RECLAMATION MINING 4 SAFETY
-2-
[phone] T-630 P.004/006 F-720
11. CorresnonLience Information:
APPLK'ANT10__P_ERATOR (name, address, and phone or name to be used on permit)
Contact's Name: a %j%s hFGGAtR Title: Q iia
Company Name: ! MMLQ2 62= KE&LIE 4 +A W Fc
Sireet/P.O. Box: P.O. Box: 221
City: ^ AT
State: r 1r 'a Gip Code: -3c s';a
Telephone Number. L '*% I- :;as- g6 i l
Fax Number: L =-10 1- :B c -- 21 0A.6
(' N'CACT (if dit7'erent from applicantloperator above)
Contact's (Jame: Title.
Company Name:
Street/P.O. Box. P.O. Box:
City:
State: Zip Code:
Tclcphone Number: ! 1-
Fax Number: [ - -
INSPECT(ON CONTACT
Contact's Name: e- CZ Z e SrFCG A Title: 'WwMc': tit sf- esQ?ZA; ia?1
Company Name:
Street/P.O.Box: P.O.Box: Z32
City:
State: Zip Code: 30 R+
Telephone Number. 33-TL 9 t t
Far Number: ( 1-43 -T -
CC: STATE OR FEDERAL (. NDOWNER (if snyl
Agency:
Street:
City:
State: Zip Code:
Telephone Number. r 1-
CC: STATE OR FEDERAL LANr-A% NER (ifs
Agency:
Street:
City:
Statr:
Telephone Number:
Zip Code: