2013-09-16_REVISION - M1983028

• Permit No: M1983028
• IBM Index Class Name: REVISION
• Doc Date: 9/16/2013
• Doc Name: Conversion Application
• From: Stone Sand & Gravel
• To: DRMS
• Type & Sequence: CN1
• Email Name: GRM
• Email Name: KAP
• Media Type: D
• Archive: No

-3-
11. Correspondence Information
APPLICANT /OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name Kathy J. Stone
Title Owner /Manager
Company Name. Stone Sand & Gravel, LLC
Street/P.O Box.
P.O. Box 1568
city Cortez
State Colorado
zip Code. 81321 -1568
Telephone Number 970 - 882 -3399 Email: [e-mail]
Fax Number 970 ) _ 882 -3395
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name:
Title.
Company Name.
Street/P O Box-
P.O. Box
City:
State
Zip Code
Telephone Number ( )
Fax Number ( ) -
INSPECTION CONTACT
Contact's Name. Same as applicant/operator
Title:
Company Name.
Street/P O Box:
P O. Box
City.
State
Zip Code.
Telephone Number )
Fax Number ) -
CC. STATE OR FEDERAL LANDOWNER (if any)
Agency: NONE
Street,
City.
State.
Zip Code.
Telephone Number ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency NONE
Street,
City:
State
Zip Code.
Telephone Number. ( -
M1983 -083 Conversion AUG13