2013-03-15_PERMIT FILE - M2013018

• Permit No: M2013018
• IBM Index Class Name: PERMIT FILE
• Doc Date: 3/15/2013
• Doc Name: 110 APPLICATION
• From: PINE BLUFFS GRAVEL & EXCAVATING
• To: DRMS
• Email Name: PSH
• Email Name: TAK
• Media Type: D
• Archive: No

1 1. Correspondence Information:
APPLICANT /OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name:
Company Name:
Street/P.O. Box:
City:
State:
Telephone Number:
Fax Number:
( 307 ) _ 245 -3426
( 307 ) _ 245 -3748
Contact's Name:
Company Name:
Street/P.O. Box:
City:
State:
Telephone Number:
Fax Number:
INSPECTION CONTACT
Contact's Name:
Company Name:
Street/P.O. Box:
City:
State:
Telephone Number:
Fax Number:
Pine Bluffs Gravel & Excavating, Inc.
Pine Bluffs
PERMITTING CONTACT (if different from applicant/operator above)
Pine Bluffs Gravel & Excavating, Inc.
Pine Bluffs
(307 ) _ 245 -3426
( 307 ) _ 245 -3748
Pine Bluffs Gravel & Excavating, Inc.
Pine Bluffs
( 307 ) _ 245 -3426
( 307- ) _ 245 -3748
CC: STATE OR FEDERAL LANDOWNER (if anv)
CC: STATE OR FEDERAL LANDOWNER (if any)
- 2 -
Tyler E Kimzey Title: President
215 Main Street P.O. Box: PO Box 609
VVY Zip Code: 82042
Doug Keller Title: Project Manager
215 Main Street P.O. Box: PO Box 609
VVY Zip Code: 82042
Doug Keller Title: Project Manager
215 Main Street P.O. Box: PO Box 609
VVY Zip Code: 82042
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -