2012-02-07_REVISION - M1977443

• Permit No: M1977443
• IBM Index Class Name: REVISION
• Doc Date: 2/7/2012
• Doc Name: Submittal- No Money Received
• From: Hardrock Sand and Gravel
• To: DRMS
• Type & Sequence: AM1
• Email Name: SSS
• Media Type: D
• Archive: No

- 2 -
11. Corresuondence Information:
APPLICANT /OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: p ,, o t web, Title: d l,!//1/ f i{
Company Name: /lime) /Qde Snwd _if (r// Viol -
Street/P.O. Box: P.O. Box: /4
City: C Rad /Cr
State: (- Zip Code: ' / , '�
Telephone Number: ( 9 70 ) - 6,? y — AM ,S—?
Fax Number. (5 76 ) - g.,?'/ - 1165 3
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Title:
Company Name: /17,1e,
Street/P.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( ) -
Fax Number. ( ) -
INSPECTION CONTACT
Contact's Name: Title:
Company Name: SA
Street/P.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( )
Fax Number. ( )
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street: C I v C
City:
State: Zip Code:
Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street: f 1 / /t e
City:
State: Zip Code:
Telephone Number: ( i -