Stormwater - Affiliates

Facility Name: GRINNELL KUM & GO #222

Permit Type: GP #2 - Construction Activity Legal Status: Private File No: 17740 Authorization No: 17740-17510

Expiration Date: 9/1/2010(discontinued) Address: 1002 WEST ST. - GRINNELL , IA 50112

County: POWESHIEK Field Office: 5 SIC: Geospatial Information: 523064(X)/4621202(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