2014-09-11_REVISION - M2010080 ‎(5)‎

• Permit No: M2010080
• IBM Index Class Name: Revision
• Doc Date: 9/11/2014
• Doc Name: Conversion application CN01
• From: Riverside Aggregates, LLC
• To: DRMS
• Type & Sequence: CN1
• Email Name: AME
• Media Type: D
• Archive: No

-3-
11. Corresnond=m -- IefgM i :
APPLICAW OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: RN* Tm= T,tle. Member
Company Name. Riverside Aggregates, LLC
Street/P.O. sox: 1750 C+My Road HH P.O. Box.
City: Lamar
State: Colorado yip Codex 81052
Telephone Number:
(719 )_ 336 -7361
Fax Number:
( I -
PE ITTINO CONTA
(if different fiom applic rt/operator above)
Contact's Name:
Title:
Company Name:
Street/P.O. Box:
P.O. Box:
City:
State:
Zip Code:
Telephone Number:
( ) -
Fax Number:
f ) -
iNSPECTION CONTACT
Contacts Name:
Rudy Twm
TWe. Member
Company Name:
Riverside Aggregates, LLC
Sbvd/P.O. Box:
1750 Ctw ty Road HH
P.O. Box:
City:
Lamar
State:
Colorado
Z'cp Cod= 81052
Telephone Number.
f 719 1-336-7361
Fax Number:
{ 2 -
CC: STA'EOR FEDERAL
Agency.
Street:
LpMONN(if am)
City:
State.
Zip Code:
Telephone Number:
CC: STATE OR FEDERAL
( ) -
LANDOWNER
Agency:
Street~
('fy)
City:
State:
Zip Code:
Telephone Number.
( ) -