2011-02-16_PERMIT FILE - M2011015 ‎(4)‎

• Permit No: M2011015
• IBM Index Class Name: PERMIT FILE
• Doc Date: 2/16/2011
• Doc Name: New 112c Application
• From: Seifert Enterprises
• To: DRMS
• Media Type: D
• Archive: No

-3-
11. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: -'rR£Nt ?TP? OQ-'37 Title: CvJt4 SV-
Company Name: g? 1 ?>L RT C'N'r? R-PR`Gi E ?_ J-c
Street/P.O. Box: _ v9? "?6.?-?t£V? P.O. Box: Z 1 D
City:
State: Zip Code: fb 1 25 z-
Telephone Number: ( :?10 1- ?g 1-457
Fax Number: (? -A 3 -
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: 4 6 ? N \f-' v<-,e Title:
???? t ENG.
Company Name:
Street/P.O. Box: P.O. Box:
City: /TOP/Ac)C 1
State: C?1-??DiU Zip Code: 2?-3
Telephone Number: f 1 1- 0)4"Z " 44 7: a
Fax Number:
INSPECTION CONTACT
r ? tJt:-2
Contact's Name: " '??Q.+F l?tT P " - Tittle:: o
Company Name: c.?icrJ? Vkozzr 4?? 1S?e.5 l -L-?
Street/P.O. Box: P.O. Box: I-N D
City:( ?L.r1F'ti
t LS Z-
State: G-o w?-I?D D Zip Code: A&
Telephone Number: ( ) - 19 3 5 c C+?? 7-10 3 / ' 1 2-3
Fax Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency:
Street:
City:
State:
Telephone Number:
Zip Code:
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency:
Street:
City:
State:
Telephone Number: ( ) -
Zip Code:
E