2015-07-06_REVISION - M2008072

• Permit No: M2008072
• IBM Index Class Name: REVISION
• Doc Date: 7/6/2015
• Doc Name: Application CN01
• From: Tim Carper
• To: DRMS
• Type & Sequence: CN1
• Email Name: ERR
• Email Name: WHE
• 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:
TM carper
Title: Owner/Operator
Company Name:
Street/P.O. Box:
42538 Co. Rd. 9
P.O. Box:
City:
Haxtun
State:
CO
Zip Code: 80731
Telephone Number.
(970 ) _774-7126
Fax Number.
PERMITTING CONTACT
(if different from applicantloperator above)
Contact's Name:
Randy Schafer
Title:
Company Name:
Street/P.O. Box:
40586 Co. Rd. 21
P.O. Box:
City:
Haxtun
State:
CO
Zip Code: 80731
Telephone Number:
( 970 ) _ 774-6264 (Home), 970-520-M2 (Cell), 9704854-3778 (Work)
Fax Number:
( 970 ) _ 854-3811
INSPECTION CONTACT
e.
Contact's Name:
Tim Carper
Title:
Company Name:
Street/P.O. Box:
(same as above)
P.O. Box:
City:
State:
Zip Code:
Telephone Number-
umberFax
FaxNumber.
( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State:
Zip Code:
Telephone Number:
( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State:
Zip Code:
Telephone Number.
( ) -