2013-05-14_PERMIT FILE - M2013028

• Permit No: M2013028
• IBM Index Class Name: PERMIT FILE
• Doc Date: 5/14/2013
• Doc Name: New 110‎(2)‎ Application
• From: Western States Minerals, LLC
• To: DRMS
• Media Type: D
• Archive: No

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9. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit):
Contact's Name: Title: 3?,rvS,\c,I-0A
Company
Street:
City: P.O. Box:
State: Zip Code:
Telephone Number:
Fax Number: E- ov cx<n
PERMITTING CONTACT (if different from applicant/operator above):
Contact's Name: Title:
Company Name:
Street: �—vnf �o, P.O. Box:
City:
State: ,,) ",/) o
Zip Code: 6
Telephone Number:
Fax Number: E-raj�
INSPECTION CONTACT:
Contact's Name:
Company Name:
Street:
City:
State:
Telephone Number:
Fax Number:
Title: Wn c\e&—
I It C' on P.O. Box:
ti
-An Zip Code:
CC: STATE- OR FEDERAL LANDOWNER (if any):
Agency:
Street:
City:
State:
Telephone Number:
CC: STATE OR FEDERAL LANDOWNER (if any):
Agency:
Street:
City:
State:
Telephone Number:
Zip Code:
Zip Code: