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<br />.~ .,.' <br /> <br />Form WM1 <br /> <br />APPLICATION FOil COLOIlAOO WEAII1EIl HOUIF [CAllUrl LlCUlSE <br />Colorado Department of Natural Ilesources . <br />1313 Sherman street, Room 71B, Denver, Colorado B0203 <br /> <br />for calendar year <br /> <br />} 'H 3 <br />. . <br /> <br />Name of applIcant: <br />SocIal Sec~rlty # of applIcant: <br /> <br />r1Rfi S. ]). St-, / il~ <br />5 ':l.& SJ.--O{)77 <br />Home address of appl1cant: J&O ~J1d X. <br /> <br />Date: <br /> <br />L--.fH(11J I k S' &,7 fJtpo <br />. <br />Phone: J/t. ~0:i 7IP'i'i <br /> <br />Name and address of present employer: WEstern Kansas Groundwater Management <br />District No.1 Phone:3l6 872-5563 <br /> <br />Please enclose lIcense fee of $100. <br /> <br />ApplIcant's Background and qualIfIcatIons (attach addItIonal pages If necessary) <br /> <br />1. EducatIon (lIst most recent fIrst) <br /> <br />InstItutIon Dates Attended Degree <br />WfSTf'Il/tuf17Ue QiU. (Uffrlt) Sf.5C-/t-W/&" B'ti <br />fAIl ;Jfjffi.- Ebk UVI.'>'. :!ufie ~ fj ~Jjn //; <br /> <br />Area of Study <br />M~. <br />MtTfid2j; Lo G--o/ <br />f <br /> <br />2. SocIetIes or professIonal organlzatlons: <br />~f:IL }J.D'bIFtCkj70J) ~f9J <br />~11 111d.emvLt/F ~c:dy <br /> <br />CO DNR/July 19, 1985 <br />