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Laserfiche Index Form <br />*Please fill out/add this form to the top of your document(s), underneath the barcoded cover sheet. <br />Permit Number H—allo//— Da From PA �� <br />Document Date�3 ( 5 <br />Index Class Type � PuqT,�,< Minerals Contact(s) �J� W� <br />Document Name,- �G . aa�s�v W��� <br />Revision Type(?) <br />Check Box if confidential <br />