2011-03-10_REVISION - M2001056

• Permit No: M2001056
• IBM Index Class Name: Revision
• Doc Date: 3/10/2011
• Doc Name: Submittal- Release of Acreage
• From: Elbert County
• To: DRMS
• Type & Sequence: AM1
• Media Type: D
• Archive: No

-2-
11. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Fn Ft4fty Iml
Title: '7,1PEald I Eli DE-9-C
Company Name: 1-i t'x I L-WNTJ Ko 0 WJ Q nj2 i_ (?!- L-.IFV 111 /rl?--/V
Street/P.O. Box: d I +iFNEW4E SERE-E-1 P.O. Box: J11D
City: V:r6W A
State: C.nL.D FLAC-0 Zip Code: gQ I I?
Telephone Number: ( 2) 3 )-
Fax
Number: - 42a ! --5 159 -303 ) PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: ea FHMArA Title: 2z)jtPEL}TAt? AEt
Company Name: E 'i- A
Street/P.O. Box: 219 COON F IN E SUES T P.O. Box: I(a
City: hTr?l ?A
State: ??Ul.6RF1Lk? Zip Code: Ab J ?'Z
Telephone Number: ( b3 ) - lid 1-3 67
Fax Number: ( 363 ) - (a --3 J. 5?1
INSPECTION CONTACT
Contact's Name:
Company Name:
Street/P.O. Box:
City:
State: C-nLM RA0O Zip Code: Aa 1 12
Telephone Number:
Fax Number:
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State:
Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State:
Zip Code:
Zip Code:
Telephone Number: ( ) -