2012-07-20_REVISION - M2004009 ‎(9)‎

• Permit No: M2004009
• IBM Index Class Name: REVISION
• Doc Date: 7/20/2012
• Doc Name: NEW AMENDMENT
• From: WSI WEILAND
• To: DRMS
• Type & Sequence: AM2
• Email Name: ECS
• Email Name: TAK
• Media Type: D
• Archive: No

- 3 -
11. Correspondence Information:
APPLICANT /OPERATOR (name, address, and phone of name to be used on permit)
'Pan tiun t
Anima 1-L 5Feaa Hies C.0. Tne_ •
A Da tla5 •
1-,enderv
Contact's Name:
Company Name:
Street/P.O. Box:
City:
State:
Telephone Number: ( O ) - 211 8 5
Fax Number:
( ?o ) - 2EN - 7? O7
Title: Pr'25i
P.O. Box:
Zip Code:D
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: ---- P)b La 1 rz me
"ter Wcty14n Land Title: itA Ci rb 9er/Rre ell ot
Company Name: A pr 1'tt ► I , �GJ 1 . l e 1 la ! I 1 C
Street/P.O. Box �e e above/ SZ� 3'd Ave, Su i 21 I P.O. Box:
City: eeabove ! Lcrv3 rncrzt dO.
State: c- ... ° e above. / C,o •
Telephone Number: ( 1- See. AAbO\fe
Fax Number: ( ) - ‘ee Ctbotte
Zip Code: See Gt1a/p l L 1
C e32 -c4 51
(�03� X32. -og53
INSPECTION CONTACT
Contact's Name: ' bb L-G4 Y
Company Name: See cote
Street/P.O. Box: `' P.O. Box:
City: If
State: Zip Code:
Telephone Number: ( ) - `
Fax Number: ( ) - t
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: N I A
Street:
City:
State: Zip Code:
Telephone Number ( 1-
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency: lj A
Street:
City:
State: Zip Code:
Telephone Number: (
Title: Land