Stormwater - Affiliates

Facility Name: KWIK STAR - CHARLES CITY

Permit Type: GP #2 - Construction Activity Legal Status: Private File No: 17305 Authorization No: 17305-17072

Expiration Date: 8/1/2010(discontinued) Address: 90 S. MAIN ST. - CHARLES CITY , IA 50616

County: FLOYD Field Office: 2 SIC: Geospatial Information: 526255(X)/4767941(Y)

Affiliates

Individual?

Type:*

Name:

Title:

Company Name:

C/O:

Address:

Address 2:

City/State/Zip

E-mail:

Contact Owner

Preferred Method of contact

Business Phone:

Error! Phone Number Format Must Be (XXX)XXX-XXXX

Ext:

Home Phone:

Error! Phone Number Format Must Be (XXX)XXX-XXXX

Fax:

Error! Phone Number Format Must Be (XXX)XXX-XXXX

Mobile Phone:

Error! Phone Number Format Must Be (XXX)XXX-XXXX